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NEGRI    IJODIES   (HIPPOCAMPUS.) 
St'itinn  stuin,\l,  follo-SKiiig  the  method  of  O.  I.entz,  Berlin. 


Carinine :     Negri  luuius.  Light  blue :     Ganglion  cells. 

Red:     Red  blood  corpustUiX.  Blue:     Nuclei  of  cells. 

Deep  blue  :     Nucleoli  of  cells. 


DISEASES  OF  THE  DOG 


AND 


THEIR  TREATMENT 


BY 

DR.  GEORG  MULLER 

PROFESSOR    DIRECTOR    OF    THE    CLINIC    FOR   SMALL    ANIMALS    AT    THE    VETERINARY 
HIGH    SCHOOL   AT    DRESDEN 


AND 

ALEXANDER  GLASS,  A.M..  V.S.  (McGill) 

LECTURER  ON  CANINE  PATHOLOGY  IN  THE  VETERINARY  DEPARTMENT 
UNIVERSITY  OF  PENNSYLVANIA 


THIRD  ILLUSTRATED  EDITION 
REVISED    AND    ENLARGED 


i 


CHICAGO 

ALEXANDER   EGER,    PUBLISHER 

1911 


/ 


f 


Entered  according  to  the  Act  of  Congress,  in  the  year  1896,  by 

ALEXANDER  GLASS,  A.  M.,  V.  S., 
In  the  Office  of  the  Librarian  of  Congress,  at  Washington,  D.  C. 

Copyright,  1908,  by 
THE  FRANKLIN  PRESS 

Copyright,  1911,  by 
THE  FRANKLIN  PRESS 


NOTE  TO  THIRD  EDITION. 


The  present  edition  of  this  work  has  been  entirely  re- written,  a 
large  amount  of  new  material  added,  and  every  endeavor  has  been  made 
to  bring  the  work  up  to  the  standard  of  the  present  day.  While  pre- 
paring the  manuscript  of  this  edition  the  second  edition  of  Dr.  Mtiller's 
work  has  appeared  and  has  been  closely  scrutinized  and  all  valuable 
additions  incorporated  in  this  work.  One  portion  of  this  work  that 
differs  materially  from  the  German  is  that  of  therapeutics.  In  the 
practice  of  Canine  medicine,  where  we  must  necessarily  administer 
medicine  by  force,  concentration  of  the  dose  is  very  essential;  the  writer 
cannot  impress  too  strongly  on  the  practitioner  and  student  that  the 
constant  aim  must  be  to  administer  all  drugs  in  doses  as  small  and 
compact  as  possible,  for  it  frequently  happens  that  the  excitement  caused 
by  the  repeated  administration  of  large  amounts  of  decoctions  and 
infusions  in  nervous  or  highly  bred  animals  does  more  harm  than  the 
original  disease. 

The  writer  is  under  great  obligation  to  Dr.  Preston  Hoskins  for  his 

suggestions  and  his  careful  reading  of  the  proof;  to  Drs.  Spang,  Sommer 

and  Jureasu  for  their  assistance  in  translation,  and  to  Dr.  Meyer  for  his 

aid  in  the  chapter  on  rabies. 
Philadelphia,  Pa., 
September,  1,  1911, 

ALEXANDER  GLASS. 


rill) 


PREFACE. 


In  writing  these  pages  tlie  author  has  endeavored  to  give  a  short, 
accurate,  and  clear  definition  of  the  modern  knowledge  of  diseases  of 
the  dog,  and  to  adapt  his  treatise  to  the  requirements  of  the  profession. 

Speculations  and  hypotheses  have  been  studiously  avoided,  while, 
on  the  other  hand,  plain  facts  have  received  careful  consideration. 

Diagnosis  has  been  given  the  most  prominent  place,  as  it  deserves 
in  a  work  of  this  kind,  and  the  author  has  endeavored  to  establish  the 
symptoms  with  their  relation  to  the  disease  and  to  confine  their  thera- 
peutic treatment  to  a  knowledge  of  normal  and  pathological  anatomy 
and  physiology,  for  he  believes  that  it  is  on  a  clear  and  accurate  knowl- 
edge of  the  normal  and  pathological  structure  of  life  the  fundamental 
base  of  clinical  science  lies. 

The  writer  has  also  included  some  selected  formulae  which  he 
considers  of  practical  value  to  the  reader. 

Due  consideration  has  been  given  to  modern  literature  whenever  it 
appeared  consistent,  and  a  glance  at  the  contents  will  also  show  that  the 
author  has  added  the  results  of  his  own  researches  and  observations. 
These  have  been  derived  from  his  experience  as  director  of  the  clinic  of 
small  animals  in  this  locality. 

His  space  has  been  somewhat  restricted,  and  he  has  had  to  dispense 
with  the  details  of  the  bibliography  of  our  literature,  but  this  is  not  of 
much  consequence  when  we  have  such  works  as  Friedberger  and  Froh- 
ner's,  Hoffmann's,  Vogel's,  and  others  at  our  disposal. 

The  illustrations  in  this  work  are  nearly  all  original.  Some,  however, 
have  been  obtained  from  other  works,  principally  from  Ellenberg  and 
Baum's  Anatomy  of  the  Dog,  edited  by  Paul  Parey,  and  the  author 
expresses  his  thanks  for  their  use. 

The  author  would  feel  gratified  if  his  work  be  favorably  received 
by  those  who  are  interested  in  the  diseases  of  the  dog. 

G.  MULLER. 


(iv) 


NOTE. 


While  lecturing  on  the  diseases  of  the  clog  the  writer  recognized  the 
fact  that  there  was  not  in  existence  a  work  that  could  really  be  called  a 
text-book  for  the  student  and  the  practitioner;  there  were  then,  and 
have  been  issued  since,  a  number  of  "popular"  works  that  endeavored 
to  fill  the  dual  role  of  text-book  for  the  veterinarian  and  a  "Dog  Book" 
for  the  layman;  these,  as  a  rule,  have  been  inadequate  for  the  former  and 
confusing  to  the  latter.  With  the  purpose  of  supplying  this  want  the 
writer,  several  years  ago,  began  to  write  a  book  on  the  subject,  but  two 
3'ears  ago  read  this  work  by  Professor  Mviller,  and  instantly  recognized 
its  value  as  a  text-book:  every  detail  in  the  diseases  of  the  dog  being 
carefully  considered,  and  the  whole  so  admirably  arranged  that  the 
student  can  readily  find  and  study  any  subject  in  a  clear  and  condensed 
form. 

He  secured  from  the  author  the  right  of  translation,  and  has  made 
it  as  exact  as  possible,  perhaps  in  some  parts  too  literal,  but  has  done  so 
in  the  endeavor  to  closely  follow  the  original.  He  has  also  added,  in 
the  proper  places,  the  results  of  his  own  observations,  and  also  every- 
thing of  value  that  has  been  added  to  veterinary  science  since  the  appear- 
ance of  Dr.  Muller's  work,  thus  making  a  second  and  much  enlarged 
edition. 

The  metric  system,  as  in  the  German  work,  has  been  followed, 
with  the  hope  that  its  use  may  be  a  slight  aid  to  the  general  adoption 
of  what  may  be  the  future  international  system  of  measurement. 

ALEXANDER  GLASS. 


(v; 


NOTE  TO  SECOND  EDITION. 


Knowing  that  many  active  and  enthusiastic  observers  are  working 
constantly  in  the  line  of  diseases  of  direct  contagion  this  edition  has 
been  delayed  in  the  hope  that  some  new  and  important  discovery  of 
original  research  would  be  made,  and  to  a  certain  extent  we  have  been 
rewarded  by  the  work  of  Babes  and  of  Negri  in  respect  to  the  quick 
diagnosis  of  Rabies.  It  has  been  thought  possible  that  some  one  might 
be  able  to  make  a  culture  of  Distemper  in  dogs  that  would  by  inoculation 
of  the  young  animal  render  it  either  immune  or  at  least  slightly  suscept- 
ible to  this  disease.     This,  however,  has  not  yet  been  accomplished. 

While  the  plan  of  the  work,  the  admirable  arrangement  of  which  is 
due  to  Dr.  Muller,  has  not  been  changed  a  great  number  of  alterations 
have  been  made.  The  articles  on  Distemper,  Rabies  and  Tuberculosis 
have  been  remodeled,  and  the  therapeutics  throughout  the  work  have 
been  brought  up  to  the  standard  of  the  present  day,  the  tendency  of 
which  appears  to  be,  and  rightly,  to  use  as  little  medicine  as  possible  and 
in  small  and  convenient  doses;  and  to  pay  particular  attention  to  hygiene, 
good  nursing,  and  sanitation  in  kennels. 

I  am  indebted  to  Dr.  John  Reichel  for  assistance  in  the  pathology 
of  Rabies,  and  to  Walter  McDougall  for  drawings.  Plates  in  color  after 
my  own  photographs  have  been  added. 

ALEXANDER  GLASS. 


(vi) 


CONTENTS. 


PAGE 

General  examination 1 

the  physical  condition 1 

the  structure  and  constitution  of  the  body 3 

the  nutritive  condition 3 

the  mucous  membranes  of  the  head 4 

skin  and  subcutaneous  membrane 5 

oedema 6 

emphysema 6 

the  temperature 7 

increased  temperature 7 

sul^normal  temperature 9 

local  temperature 10 

Diseases  of  the  digestive  apparatus 11 

the  examination  of  the  digestive  apparatus 11 

the  condition  of  the  throat  and  niouth 12 

examination  of  the  oesophagus      16 

examination  of  the  stomach 17 

digestion  of  a  meat-diet  in  the  stomach 22 

the  digestion  of  milk  in  the  stomach 22 

action  of  digestion  on  hydronaceous  food 22 

physical  examination  of  the  bowels      25 

the  faeces 28 

physical  examination  of  the  liver 32 

examination  of  the  spleen       33 

examination  of  the  pancreas      33 

diseases  of  the  mouth,  tongue,  and  salivary  glands 34 

inflammation  of  the  mucous  membrane  of  the  mouth 34 

ulcerous  inflammation  of  the  mouth 34 

foreign  bodies  in  the  tongue 36 

gangrene  of  the  tongue 36 

diseases  of  the  teeth 37 

dentition 40 

malformations  of  the  ca\'ity  of  the  mouth 41 

warts  in  the  mouth 42 

ranula 42 

inflammation  of  the  salivary  glands ' 43 

parotitis 43 

idiopathic  parotitis      43 

abscess  of  the  glands 44 

inflammation  of  the  mucous  membrane  of  the  throat 46 

diseases  of  the  oesophagus      48 

(vii) 


viii  CONTENTS 

Diseases  of  the  digestive  apparatus — Continued.  page 

foreign  bodies  in  the  oesophagus 48 

CESophagitis 50 

stenosis      50 

dilatation  of  the  oesophagus 51 

paralysis  of  the  oesophagus 51 

diseases  of  the  stomach 52 

acute  catarrh  of  the  stomach 52 

chronic  catarrh  of  the  stomach 53 

other  disorders  of  the  stomach      54 

diseases  of  the  intestines 58 

intestinal  catarrh 58 

mycotic  inflammation  of  the  stomach  and  intestines 63 

constipation      64 

obstipation 65 

prolapsus  of  the  rectum      74 

imperforate  anus 78 

hemorrhoids      81 

intestinal  parasites 82 

round  worms 82 

tapeworms 84 

oxyuris  vermicularis 93 

dochmius 93 

other  parasites 94 

diseases  of  the  peritoneum 95 

inflammation  of  the  peritoneum 95 

abdominal  dropsy 99 

diseases  of  the  liver 104 

catarrhal  jaundice 104 

hypersemia  of  the  liver 107 

inflammation  of  the  liver 108 

acute  parenchymatous  inflammation  of  the  liver 108 

interstitial  hepatitis 108 

abscess  of  the  liver 109 

fatty  liver 109 

neoformations  of  the  liver  and  gallstones 110 

amyloid  liver 110 

lardaceous  liver 110 

poisons Ill 

Diseases  of  the  respiratory  organs 115 

the  physical  examination  of  the  respiratory  apparatus 115 

examination  of  the  nose 115 

physical  diagnosis  of  the  larynx  and  windpipe 117 

physical  diagnosis  of  the  lungs      119 

shape  of  the  cavity  of  the  chest 119 

number  and  character  of  the  respiratory  movements 120 

percussion  of  the  thorax 123 

auscultation  of  the  thorax 125 

diseases  of  the  nasal  ca\'ities 128 

nasal  catarrh 128 


CONTENTS  ix 

Disease  of  the  respiratory  organs — Continued.  page 

pentastoma  taenioides 128 

epistaxis 129 

tumors 130 

diseases  of  the  larynx 133 

acute  laryngeal  catarrh 133 

chronic  catarrh  of  the  larynx 135 

diseases  of  the  upper  air-passages  and  bronchial  tubes 137 

catarrh  of  the  windpipe  and  bronchia 137 

acuts  catarrh  of  the  large  bronchia 138 

acute  catarrh  of  the  smaller  bronchia 139 

parasitic  bronchitis      140 

diseases  of  the  lungs 141 

catarrhal  inflammation  of  the  lungs 141 

chronic  interstitial  pneumonia 143 

cedema  of  the  lungs 144 

croupous  inflammation  of  the  lungs 146 

anthracosis  pulmonum 146 

emphysema  of  the  lungs 146 

diseases  of  the  pleura      147 

pleuritis 147 

hydrothorax 151 

pneumothorax      152 

hjematothorax , 153 

Diseases  of  the  circulatory  apparatus 154 

examination  of  the  circulatory  apparatus 154 

examination  of  the  heart 154 

position  and  size  of  the  heart 155 

character  of  the  heart-pulsations 156 

character  of  the  heart-sounds  and  bruits 156 

character  of  the  jjulse 157 

diseases  of  the  heart 158 

valvular  defects 160 

idiopathic  hypertrophy  of  the  heart 163 

diseases  of  the  pericardium 165 

pericarditis 165 

dropsy  of  the  pericardium      166 

hemorrhage  of  the  pericardium 166 

filaria  in  the  blood 167 

Diseases  of  the  urinary  and  sexual  apparatus 169 

examination  of  the  urinary  apparatus 169 

examination  of  the  prepuce  and  urethra 169 

examination  of  the  prostate 171 

examination  of  the  bladder 172 

examination  of  the  urine 173 

amount  of  urine 173 

color  of  the  urine 174 

transparency  of  the  urine 175 

the  specific  gravity  of  the  urine 1"^ 


X  CONTENTS 

Disease  of  the  urinary  and  sexual  apparatus — Continued  page 

foreign  substances  in  the  urine      175 

diseases  of  the  kidneys 181 

inflammation  of  the  kidneys      181 

acute  inflammation  of  the  kidneys 182 

chronic  inflammation  of  the  kidneys .  184 

amyloid  kidney ' 186 

abscess  of  the  kidneys 187 

inflammation  of  the  pelvis  of  the  kidney 188 

hydronephrosis 189 

cysts  of  the  kidneys 189 

nephritic  stones 190 

tumors  of  the  kidneys 190 

animal  parasites  of  the  kidneys 190 

diseases  of  the  bladder 191 

catarrh  of  the  bladder 191 

debilitated  conditions  of  the  bladder 195 

stone  in  the  bladder 197 

urethrotomy 199 

Diseases  of  the  male  sexual  organs 204 

diseases  of  the  prostate 204 

inflammation  of  the  prostate 204 

hypertrophy  of  the  prostate 205 

tumor  of  the  prostate 206 

diseases  of  the  penis  and  prepuce 206 

phiniosis  and  paraphimosis 206 

gonorrhoea 207 

specific  gonorrhoea 208 

neoformations  of  the  glands  and  prepuce 208 

diseases  of  the  testicle  and  its  coverings 208 

inflammation  of  the  scrotum 208 

injuries  to  the  testicle  and  scrotum      209 

cuterebro  emasculator 211 


Diseases  of  the  female  sexual  organs 211 

diseases  of  the  vagina  and  uterus 211 

inflammation  of  the  vulva  and  vagina 211 

prolapsus  of  the  vagina  and  uterus 212 

diseases  of  the  uterus      215 

inflammation  of  the  uterus 215 

catarrhal  metritis 215 

septic  metritis 216 

obstetrics 219 

irregularities  of  the  sexual  instinct 222 

castration  of  the  bitch 223 

diseases  of  the  mammary  gland 225 

inflammation  of  the  mammary  gland 225 

neoformations  of  the  mammarv  gland 226 


COXTENTS  xi 

PAGE 

Diseases  of  the  nervous  system 228 

examination  of  the  nervous  system      228 

disturbances  of  consciousness 228 

disturbances  of  sensitiveness 228 

disturbance  of  motility 229 

diseases  of  the  brain  and  its  coverings 235 

hyperaemia  of  the  brain 235 

anaemia  of  the  brain 236 

cerebral  hemorrhage 237 

traumatic  lesion 238 

inflammation  of  the  brain       239 

comparatively  rare  diseases  of  the  brain 241 

diseases  of  the  spinal  cord  and  its  memlsranes 243 

cerebro-spinal  meningitis 243 

inflammation  of  the  spinal  cord  and  its  membranes       243 

paralysis  of  the  nerves 252 

epilepsy 255 

chorea 259 

catalepsy 262 

bronchocele 264 

Diseases  of  true  infection 267 

distemper       267 

infectious  bronchial  catarrh 267 

infectious  hemorrhagic  gastroenteritis 282 

Septic  and  pyaemic  diseases 287 

septicopyaemia       287 

malignant  oedema 288 

anthrax 289 

rabies 290 

tuberculosis       302 

hemoglobinuria  and  piroplasosis 307 

tetanus       309 

Constitutional  diseases 312 

anaemia       312 

leukaemia 313 

diabetes  mellitus      316 

diabetes  insipidus 318 

obesity       319 

uraemia       320 

uraemia       320 

scurvy 321 

Priessnitz's  bandage 322 

Diseases  of  the  organs  of  locomotion 323 

diseases  of  the  bones 323 

rhachitis 323 

fractures  of  the  bones 325 


xii  CONTENTS 

PAGE 

Diseases  of  the  articulations 337 

inflammation  of  the  joints 337 

acute  synovial  inflamniation  of  the  joints 338 

chronic  synovial  inflammation  of  the  joints 339 

purulent  inflammation  of  the  joints 339 

rheumatic  inflammation  of  the  joints       340 

disease-producing  malformation  of  the  joints 341 

Injuries  of  the  joints 344 

wounds  of  the  joints 344 

contusions  of  the  joints       345 

distortions  of  the  joints       346 

luxation  of  the  joints       347 

dislocation  of  the  lower  jaw 348 

dislocation  of  the  ell^ow 349 

dislocation  of  the  patella 350 

Diseases  of  the  muscles 353 

muscular  rheumatism 353 

cysticercus  and  trichina      355 

diseases  of  tendons  and  bursa  mucosa 356 

Wounds  and  their  treatment       359 

wounds       359 

course  and  healing  process  in  a  wound 361 

diseases  resulting  from  septic  infection  of  wounds 361 

treatment  of  wounds       365 

ulcers  and  ulcerations 369 

contusions 370 

Diseases  of  the  claws  and  foot-pads      378 

ingrowing  claws 378 

inflammed  claw 379 

contusions  and  wounds  of  pads 380 

Hernial  rupture 381 

abdominal  hernia 381 

description  of  hernia 381 

reducible  hernia 382 

irreducible  hernia 383 

inguinal  hernia        387 

method  of  castration       388 

sarcocele 391 

hydrocele       391 

umbilical  hernia 391 

femoral  hernia      393 

perineal  hernia 394 

Diseases  of  the  eyes 395 

affections  of  the  eyelids      395 

closure  of  the  eyelids       395 

entropion       395 

ectropion 397 


CONTENTS  xiil 

Disease  of  the  Eyes — Continued  page 

diseases  of  the  conjunctiva 401 

inflammation  of  the  conjunctiva       . 401 

catarrhal  conjunctivitis       402 

purulent  conjunctivitis 403 

diseases  of  the  cornea '. 406 

inflammation  of  the  cornea 406 

keratitis  superficialis 407 

keratitis  profunda  or  parenchymatosa 408 

abscess  of  the  cornea       409 

ulceration  of  the  cornea      410 

dermoid  of  the  cornea 413 

pterygium 414 

injuries  to  the  cornea      414 

diseases  of  the  lens,  cataract 416 

diseases  of  the  sclerotic  membrane,   of  the  nervous  portion   of  the  eye, 

and  of  the  vitreous  humor 422 

inflammation  of  the  iris      422 

purulent  inflammation  of  the  eye 423 

dropsy  of  the  anterior  chamber  (glaucoma) 423 

diseases  of  the  optic  nerve  and  the  retina 424 

prolapsus  of  the  eyeball      425 

Diseases  of  the  ear 429 

serous  cyst 429 

external  canker 432 

internal  canker  (otitis) 434 

deafness,  partial  or  complete 438 

prasitic  canker  of  the  ear 439 

Diseases  of  the  skin 441 

inflammatory  condition.s  of  the  cutaneous  membrane 441 

erythema       442 

urticaria 444 

eczema       445 

acne 455 

alopecia 458 

cutaneous  affections  caused  by  animal  parasites      461 

ceratopsyllus  canis 462 

haematopinus  piliferus       463 

trichodectes  latus      464 

Ixodes  ricinus 465 

leptus  autumnalis 465 

cutaneous  diseases  due  to  animal  parasites 465 

sarcoptic  mange 465 

follicular  mange 469 

demodex  follicularum 469 

filaria 474 

cutaneous  affections  caused  by  vegetables  parasites      475 

favus       4/0 

herpes  tonsurans       4/6 

trypanosomiasis        4/8 


xiv  CONTENTS 

PAGE 

Tumors      480 

soft  and  hard  fibroma 480 

lipoma 481 

sarcoma 482 

papilloma      483 

warts 483 

flat  condyloma 483 

484 
carcinoma ^°^ 

myxoma 4oo 

adenoma 48o 

anojioma 48o 

487 
myoma      • 

chondroma 487 

infectious  genital  tumors 488 


ILLUSTRATIONS. 


FIG.  PAGE 

1.  Dog  ^^■ith  a?dema  of  the  skin 6 

2.  Laryngoscope 12 

3.  Pocket  electric  light 12 

4.  Holding  the  mouth  open  with  tapes 13 

5.  Mouth  speculum 14 

6.  Gag 14 

7.  Section  through  center  of  abdomen 18 

8.  Position  of  stomach  when  empty 19 

9.  Position  of  stomach  when  full 19 

10.  Stomaeh-pumi3 20 

11.  Contents  of  the  stomach  (four  hours  after  eating) 21 

12.  Intestinal  canal  of  the  dog 26 

13.  Examnation  of  the  lower  bowel  with  speculum 28 

14.  Microscopical  examination  of  the  fajces 30 

15.  Eggs  of  intestinal  parasites  in  fseces  (round  worm) 31 

16.  Right  side  of  the  abdomen 32 

17.  Gangrene  of  the  tongue 37 

18.  Longitudinal  section  through  an  incisor  tooth 37 

19.  Improvised  gag 39 

20.  Tumors  of  the  gums 40 

21.  "Wire  6craseur 41 

22.  Warts  of  the  mouth 41 

23.  Glands  of  the  head 43 

24.  Abscess  of  the  neck 45 

25.  Mucous  cyst 45 

26.  SpirojDtera  Sanguinolenta       51 

27.  X-ray  picture  of  coin  in  the  stomach      56 

28.  Dog  ^vith  obstruction  of  the  intestines 67 

29.  Mode  of  administering  a  clyster 69 

30.  Lamlsert  suture '^0 

31.  Suture  of  the  intestines "1 

32.  Hairpin  method  of  anastomosis 72 

33.  Hairpin  method  of  anastomosis,  first  stage 73 

34.  Hairpin  method  of  anastomosis,  second  stage        73 

35.  Prolapsus  of  the  rectum  with  invagination 75 

36.  Stitching  rectum  (tobacco-bag  stitch) ■  77 

37.  Method  of  suturing  in  amputation  of  the  lower  bowel 77 

38.  Inflammation  of  the  anal  glands '9 

39.  Pseudo-perineal  hernia 80 

40.  Ascaris  mystax S2 

41.  L^terus  of  the  Taenia  coenurus  (enlarged) 85 

42.  Taenia  serrata ^^ 

43.  Taenia  marginata,  posterior  end  of  worm 86 

44.  Taenia  cucumerina,  DipyUdium  caninum 87 

45.  Taenia  ccenurus 88 

(XV) 


xvi  ILLUSTRATIONS 

FIG.  PAGE 

46.  Tsenia  echinococcus 89 

47.  Taenia  echinococcus 90 

48.  Oxyuris  vermicularis 93 

49.  Anchylostomum  uncinaria 94 

50.  Wall  of  cajciim  with  trichocephalus  depressiusculus 95 

51.  Section  through  the  abdomen 96 

52.  Dog  with  ascites 99 

53.  Diagramatic  section  of  the  pharynx 116 

54.  Position  of  the  frontal  sinuses       117 

55.  Right  side  of  the  thorax  and  abdomen 120 

56.  Left  side  of  the  thorax  and  abdomen 121 

57.  Pleximeter 123 

58.  Field  of  percussion 124 

59.  Stethoscope 125 

60.  Dog  Avith  chronic  catarrh      130 

61.  Pentastoma  taenoides 131 

62.  Cross-section  of  the  head  of  a  dog 131 

63.  Pentastomum  denticulatum      132 

64.  Egg  of  the  Pentastomum  tenoides 132 

65.  Trocars  for  puncture  of  the  thorax 151 

66.  The  heart  in  position 154 

67.  Diagram  of  the  blood  circulation 160 

68.  Heart,  with  filaria  immitis  in  the  ventricle 167 

69.  Male  catheter 169 

70.  Passing  the  catheter 170 

71.  Female  catheter 171 

72.  Median  section  through  the  pelvic  cavity 171 

73.  Speculums 172 

74.  Section  through  the  pelvis  of  the  male 172 

75.  Areapikometer 175 

76.  Spectrum  of  urine  in  hajmoglobinuria 176 

77.  Haematin  crystals 176 

78.  Epithelium  found  in  the  urine 178 

79.  Uric  cylinders      178 

80.  Urine  of  a  dog  with  cystitis      179 

81.  Urine  of  a  dog  with  cystitis      193 

82.  Apparatus  and  method  of  irrigating  the  bladder 194 

83.  Urethrotomy 200 

84.  Enlargement  of  scrotum 210 

85.  Vaginal  speculum 212 

86.  Prolapse  of  the  vagina 213 

87.  The  genito-urinary  organs  of  the  bitch 214 

88.  Double  catheter  for  washing  out  the  uterus 216 

89.  Retractors,  single  and  double 220 

90.  Apparatus  for  the  extraction  of  foetus 221 

91.  Tumor  of  the  mammary  gland 226 

92.  Diagram  of  the  brain,  showing  the  various  motor  centers 231 

93.  Motor  centre  points  of  the  dog 232 

94.  Paralysis  of  the  posterior  extremities      244 

95.  Paralysis  of  the  cord       247 

96.  Dog  with  })achymeningitis  ossificans 248 


ILLUSTRATIONS  xvii 

Fig.  page 

97.  Facial  paralysis  of  the  left  side 253 

98.  Malignant  struma 265 

99.  Blood  of  a  dog  affected  with  piroplasma  canis      307 

100.  Dog  with  tetanus 310 

101.  The  blood  in  leukocytha^mia 314 

102.  Rixdius  and  ulna  of  dog  affected  with  rickets 324 

103.  Skiagraph  of  fracture  of  the  humerus 327 

104.  Diagram  of  union  of  fracture  in  the  tibia  of  the  dog 328 

105.  Plaster  splint  on  fracture  with  support  around  body 330 

106.  Pitch  plaster  put  on  in  layers 332 

107.  Effects  of  tight  bandaging  of  a  sphnt 332 

108.  Different  methods  of  amputation - 333 

109.  Skiograph  of  osteosarcoma  of  the  radius  with  opening  in  upper  part  of  the 

bone      335 

110.  Skiagrajih  of  the  ulna  \vith  middle  and  lower  third  of  the  bone  nearly  gone.    335 

111.  A  large  hv]wdermatic  syringe  for  puncturing  enlarged  joints 343 

112.  Muzzle 349 

113.  Dog  with  dislocation  of  the  hip 351 

114.  Skiograph  of  luxation  of  the  hip 352 

115.  Laceration  of  the  tendo  achilles 356 

116.  Dog  with  elbow  boil  (hygroma) 357 

117.  Apparatus  for  the  antiseptic  irrigation  of  wounds 366 

118.  Different  forms  of  stitches 367 

119.  Muzzle 368 

120.  Bandage  for  injuries  or  amputation  of  the  tail 375 

121.  Amputation  of  the  tail 376 

122.  Longitudinal  section  of  the  nail 378 

123.  Diagram  of  the  first  and  second  phalanx 378 

124.  Pads  of  foot 379 

125.  Dog's  shoes      380 

126.  Scrotal  hernia  of  right  side 387 

127.  Genital  organs  of  the  dog 389 

128.  Inguinal  hernia  of  bitch 390 

129.  Umbilical  hernia 392 

130.  Plaster  on  umbilical  hernia 392 

131.  Middle  section  through  the  pelvis  sho-\ving  the  organs 393 

132.  Double  perineal  hernia 394 

133.  Entropion  operation  of  lower  eyelid 396 

134.  Diagrammatic  position  of  sections  and  mode  of  stitching  in  operation  for 

entropion 397 

135.  Diagrammatic  position  of  section  in  operation  of  entropion 397 

136.  Entropion  operation 398 

137.  Entropion  operation  and  mode  of  stitching 398 

138.  Protrusion  of  the  membrana  nictitans 400 

139.  Removal  of  the  membrana  nictitans 400 

140.  Dermoid  of  cornea      413 

141.  Leucoma 415 

142.  Gray  cataract  of  both  eyes 417 

143.  Instruments  used  in  the  cataract  operation 418 

144.  Discission  of  the  lens 419 

145.  Lobular  extraction  of  lens 420 


i 


xviii  ILLUSTRATIONS 

TIG.  PAGE 

146.  Lobular  extraction  of  lens 421 

147.  Dislocation  of  the  lens 421 

148.  Iris  coloboma 423 

149.  Dislocation  of  the  eyeball 426 

150.  Muscles  of  the  left  eye 428 

151.  Hematoma  of  the  ear 430 

152.  Ear-cap 430 

153.  Earhood  or  net 431 

154.  Mode  of  bandaging  the  ear 432 

155.  Mode  of  bandaging  the  ear 433 

156.  Kramer's  ear  speculum 435 

157.  Ear  swab  and  mode  of  using  it 436 

158.  Moist  eczema  of  the  shoulder 447 

159.  Chronic  eczema  of  the  back 448 

160.  Acne  of  the  nose 455 

161.  Acne  muzzle 456 

162.  Head  of  the  dog  flea 462 

163.  Female  pulex  pentranse 463 

l64a.  Haematopinus  filiferus 464 

1646.  Trichodectes  latus 464 

165.  Ixodes  ricinus 465 

166.  Female  sarcoptes  of  the  dog 466 

167.  Female  sarcoptes  burrowing  in  the  skin 466 

168.  Development  of  the  acarus  folliculorum 469 

169.  Acarus  folliculorum  greatly  magnified 469 

170.  Hair  follicle  invaded  by  demodectes  folliculorum 469 

171.  Head  of  dog  affected  with  demodectes  folliculorum 472 

172.  Favus  spores 475 

173.  Trichophyton  tonsurans  after  treatment 476 

174.  Dependent  fibroma 481 

175.  Multiple  formation  of  warts 483 

176.  Chronic  ulcer 490 

177.  AVire  ^craseur 491 

178.  Manner  of  tying  the  mouth 492 

FULL  PAGE  PLATES. 

Negri  bodies  (hippocamous)  section  stained,  following  the  method  of  O.  Lenz, 

Berlin Frontispiece 

Stomacace  (necrotic  gangrene  of  the  jaw) 34 

Ranula  (salivary  cyst  of  the  tongue) 42 

Spiroptera  sanguinolenta  (encysted  in  the  oesophagus) 50 

Method  of  administering  medicinal  vapors 136 

Section  of  the  hippocampus  major,  showing  Negri  bodies 298 

A  smear  of  mucous  from  the  bronchial  membrane  of  a  dog 306 

Cultivation  of  a  tubercular  bacilli 310 

Tetanus  (lockjaw) 310 

Rachitis  (rickets) 324 

Dermodectes  folliculorum.  (dermodictic  mange.)  a 470 

Infective  tumor  of  dogs  (natural  size) 488 

Infective  genital  tumor  of  dogs  (the  initial  stage) 488 

Infective  genital  tumor  of  dogs  (the  fully  developed  stage) 490 


DISEASES  OF  THE  DOG. 


GENERAL  EXAMINATION. 

In  making  an  examination  of  the  dog  for  the  purpose  of  diagnosis  it  is 
best  to  class  it  under  two  heads:  a  general  and  a  special  examination. 

The  general  examination,  used  when  the  organism  is  considered  as  a 
whole,  is  the  method  generally  followed  in  surgical  diseases,  as  in  the  case 
of  an  injury  where  we  first  carefully  examine  the  injured  region  and  then 
direct  our  attention  to  the  other  parts  of  the  body. 

The  special  examination  is  made  when  we  consider  single  special 
organs  of  the  body,  particularly  those  of  secretions  and  excretions.  If 
our  attention  is  called  to  some  specially  striking  symptom,  we  at  once 
examine  a  certain  organ  or  group  of  organs.  Frequently,  for  more  cer- 
tain diagnosis,  it  is  necessary  to  make  a  microscopical  examination  of 
the  blood,  urine,  or  faeces;  or  by  means  of  a  trocar  obtain  some  of  the  con- 
tents of  certain  cavities  or  tissues  of  the  body  to  ascertain  their  true  char- 
acter and  composition.  The  Rontgen  rays  are  also  used  to  obtain  a 
photograph  of  some  foreign  body  or  pathological  alteration  of  the  inner 
structures;  or  the  skin  examined  to  detect  the  presence  of  parasites  or 
their  embryos;  and  it  may  be  necessary  in  some  instances  to  inoculate 
another  animal  or  series  of  animals  with  the  virulent  material  of  some 
disease  to  confirm  a  diagnosis. 

In  making  a  general  examination  the  following  points  have  to  be 
observed:  1.  The  physicial  condition;  2.  the  structure  and  constitution; 
3.  the  nutritive  condition;  4.  the  mucous  membranes  of  the  head;  5. 
the  skin  and  subcutaneous  membranes;  and  6,  the  temperature  of  the 
body. 

THE  PHYSICAL  CONDITION. 

The  physical  condition  of  the  dog  suffering  from  any  bodily  ailment 

presents  more  rapid  and  marked  changes  than  any  other  animal.     Even 

in  slight  indispositions,  such  as  disturbances  of  the  stomach  and  digestive 

apparatus,  the  animal  will  be  downcast,  irritable  and  nervous,  and  often 

1  1 


2  GENERAL  EXAMINATION 

show  a  disinclination  to  move,  or  may  change  constantly  from  one  place 
to  another.  Nervousness,  a  staring  look  in  the  eyes,  great  restlessness, 
constant  barking  or  howling  point  to  beginning  of  congestion  of  the  brain. 
But  these  symptoms  may  also  be  found  in  a  number  of  other  diseases; 
for  instance,  in  cases  of  pentastomes  in  the  nose  or  cavity  of  the  forehead, 
in  cases  of  parasites  of  the  intestines,  in  rabies  and  distemper. 

Howling  is  observed  in  a  great  many  of  the  various  painful  diseases, 
particularly  in  disorders  of  the  stomach  and  intestines.  Colic  of  the  intes- 
tines may  present  great  nervous  excitement;  a  nervous  animal  sometimes 
will  swallow  indigestible  substances,  foreign  bodies,  show  a  tendency  to 
bite,  but  that  does  not  necessarily  mean  that  the  animal  has  rabies;  but 
if  this  is  accompanied  by  a  hoarse,  howling  bark  and  a  staggering  gait, 
it  will  change  the  existing  suspicion  to  a  certainty. 

Symptoms  resembling  rabies  may  appear  from  the  presence  of  pen- 
tastomes in  the  nasal  cavities,  from  taenia  ecchinococcus  in  the  intestines, 
foreign  bodies  between  the  teeth,  in  the  pharynx,  stomach  and  intestines, 
or  as  the  result  of  continuous  sexual  excitement.  Further,  we  may 
may  have  uncontrollable  movements  which  are  caused  by  changes  in  the 
physical  condition;  they  appear  in  certain  circumscribed  diseases  of  the 
cerebrum  and  cerebellum  or  from  cysts,  tumors,  abscesses,  hemorrhages 
of  the  brain  and  in  certain  forms  of  poisoning  or  from  distemper, 
slight  convulsions,  etc.,  but  this  subject  will  be  taken  up  in  detail 
later  on. 

Dulness  or  total  indifference  to  external  influences,  staring  expres- 
sion of  the  eye,  a  slow  staggering  gait,  sleepiness  or  coma  (entire 
unconsciousness),  are  seen  in  the  various  diseases  of  the  brain  and  its 
coverings,  from  injury  to  the  skull,  or  to  shock,  in  serious  infectious  dis- 
eases, such  as  distemper,  septicaemia  and  infectious  hemorrhage,  gastro- 
enteritis, in  poisoning  by  some  narcotics,  or  uraemia,  acute  jaundice, 
acute  anaemia  and  in  all  diseases  that  are  terminating  fatally. 

In  some  cases  we  see  short  attacks  of  unconsciousness  brought  on 
by  great  excitement  and  pain,  as  in  surgical  operations,  cysts  in  the 
brain,  anaemia,  continued  hemorrhage,  abscess  or  tumors  in  the  brain, 
effects  of  certain  poisons,  etc.;  for  further  information  on  this  subject  see 
article  on  the  examination  of  the  nervous  system.  In  making  an  exami- 
nation of  the  physical  condition  of  an  animal,  we  must  always  take  into 
consideration  the  fact  that  the  symptoms  may  be  very  much  modified 
by  the  presence  of  strangers  or  the  veterinarian;  on  the  other  hand,  pet 
dogs  may  often  hide  certain  symptoms,  or  from  fear  may  present  symp- 
toms that  are  very  much  exaggerated. 

Very  sick  animals  will  not  rise  when  called  by  a  stranger  or  even  by 
the  owner  when  a  stranger  is  present,  while  a  healthy  animal  will  rise 
or  bark,  and  show  its  presence  in  various  ways.     The  position  of  the 


GENERAL  EXAMINATION  3 

animal  when  lying  down  is  to  a  certain  extent  a  diagnostic  symptom. 
Dogs  which  are  affected  by  lateral  or  one-sided  diseases  of  the  chest,  for 
instance,  lateral  pneumonia,  pleurisy,  or  pneumothorax,  ;vvill  take  a  sitting 
position  or  lie  on  the  sternum  with  the  legs  under  the  body. 

THE  STRUCTURE  AND  CONSTITUTION  OF  THE   BODY. 

The  development  of  the  skeleton  may  be  used  as  a  basis  for  deter- 
mining what  sort  of  constitution  an  animal  has,  at  the  same  time  taking 
into  consideration  the  great  difference  there  is  in  form  between  the  differ- 
ent breeds  of  dogs  in  the  strength  and  shape  of  the  bones;  we  can  fre- 
quently obtain  some  diagnostic  information  concerning  a  defective  con- 
stitution from  the  following  indications:  of  softness  of  bones,  there  are 
flat  non-arched  ribs,  a  narrow  chest,  a  marked  change  in  the  shape  of  the 
skeleton,  the  swelling  of  the  ends  of  the  ribs  at  the  union  of  the  bone  to 
the  sternum,  by  the  contortions  of  long  bones,  and  a  swelling  of  the  joints 
as  seen  in  all  rachitic  animals.  For  further  information  on  this  subject  see 
the  article  on  the  examination  of  the  respiratory  apparatus.  In  rare 
instances  there  is  a  marked  deformity  of  the  spinal  column,  an  upward 
curvature  (kyphosis) ,  a  lateral  curvature  (skoliosis) ,  an  upward  and  lateral 
curvature  (kyphoskoliosis) ,  and  a  downward  curvature  (lordosis) . 

THE  NUTRITIVE  CONDITION. 

The  general  condition  may  depend,  to  a  large  extent,  on  the  age  of 
the  animal,  how  he  has  been  fed,  and  the  amount  of  exercise  he  has  had, 
but,  as  a  general  rule,  if  the  animal's  condition  is  poor,  it  is  due  to  the 
presence  of  some  disease.  The  skin,  to  a  certain  extent,  is  a  diagnostic 
guide;  if  the  animal  is  healthy  the  skin  will  be  loose  and  pulled  easily  from 
the  different  parts  of  the  body,  whereas  in  disease  it  is  tight  and  loses  its 
softness  and  smooth  feeling  to  the  fingers.  The  body  loses  its  symmetry, 
the  eyes  are  sunken  in  their  sockets.  In  slight  cases  of  emaciation  we 
must  depend,  to  a  certain  extent,  on  the  history  of  the  cases  from  the 
owner.  Weighing  the  animal  is  also  useful  to  determine  whether  an 
animal  is  gaining  or  losing  during  the  course  of  treatment;  this  is  especi- 
ally valuable  where  the  animal  is  being  reduced  in  cases  of  plethora,  or  in 
convalescence  from  acute  disease;  the  gain  shows  that  the  animal  is  im- 
proving; but  at  the  same  time  we  must  not  lose  sight  of  the  fact  that  we 
may  have  an  increase  of  weight  from  csdema,  or  any  dropsical  condition. 
A  rapid  emaciation  is  seen  in  diseases  of  the  digestive  apparatus,  in  all 
acute  and  chronic  feverish  affections,  in  certain  cases  of  poisoning,  and  in 
rabies.  A  gradual  loss  of  flesh  may  be  seen  in  cachexia,  as  a  result  of 
chronic  infectious  and  constitutional  diseases,  such  as  tuberculosis,  leu- 


4  GENERAL  EXAMINATION 

kirmia,  diabetes,  carcinoma,  and  in  chronic  nephritis.  A  slight  loss  of 
flesh  is  also  seen  following  surgical  operations.  As  an  opposite  to  ema- 
ciation, we  may  see  a  rapid  accumulation  of  adipose  tissue;  this  may 
occur  from  laziness,  a  disinclination  to  take  exercise  or  resist  it  when 
forced  to  do  so,  or  to  close  confinement  where  the  animal  is  the  pet  of  a 
sick  person.  Disturbances  of  the  respiratory  and  circulatory  apparatus 
have  a  tendency  to  produce  accumulations  of  fat  in  the  abdominal  and 
thoracic  walls,  in  the  pericardium,  and  in  the  heart. 

THE  MUCOUS  MEMBRANES  OF  THE  HEAD. 

In  making  a  general  examination,  the  first  thing  to  do  is  to  examine 
the  visible  mucous  membranes,  to  see  the  color  of  them,  the  conjunctiva, 
and  also  of  the  mouth  and  throat.  It  is  best  to  examine  more  than  one 
mucous  membrane,  as  the  examination  of  one  only  may  lead  to  an  error 
in  diagnosis.  Rapid  exercise,  particularly  in  hot  weather  or  in  high  wind, 
may  produce  a  temporary  congestion  of  the  mucous  membranes.  Red- 
dening of  the  eyes  is  often  a  perfectly  normal  condition  in  some  breeds  of 
dogs.  Abnormal  paleness  of  the  mucous  membranes  may  be  due  to 
decrease  in  the  amount  of  blood  in  the  system  from  severe  internal  or 
external  hemorrhage,  or  from  slight  but  frequent  hemorrhage  internally. 
It  may  be  due  to  decrease  in  the  amount  of  haemoglobin  in  the  blood 
corpuscles,  in  diseases  peculiar  to  the  blood,  as  in  ansemia,  leukaemia, 
pseudo-leukeemia,  and  in  all  diseases  producing  great  loss  of  fluids,  such 
as  disease  of  the  kidneys,  disease  of  the  stomach  and  the  bowels,  in  tuber- 
culosis, carcinoma  and  also  in  slow  pus  formations  that  are  accompanied 
with  or  without  fever,  in  defective  heart  action,  as  in  collapse,  where  the 
heart's  action  is,  to  a  certain  extent,  paralyzed  for  the  time,  as  in  many 
acute  diseases  or  violent  poisons,  or  from  depressing  drugs;  also  in  dis- 
eases of  the  heart  and  its  covering,  the  pericardium.  A  blue  or  cyanotic 
coloring  is  sometimes  seen  where  there  is  defective  oxygenation  of  the 
blood  and  it  is  loaded  with  carbon  dioxide.  This  is  also  seen  where  the 
blood  in  the  lungs  does  not  come  in  contact  with  oxygen,  as  in  contract- 
ion of  the  trachea  or  larynx,  or  by  the  inflammation  or  swelling  of  these 
parts,  foreign  bodies,  internal  or  external  tumors,  pressing  on  the  air- 
passages;  also  in  acute  bronchitis,  in  the  various  forms  of  pneumonia,  in 
large  pleuritic  exudates,  in  hydrothorax,  in  severe  ascites  where  the  dia- 
phragm is  pressed  on,  in  rigidity  of  the  muscles,  as  in  eclampsia  in  bitches, 
in  strychnine  poisoning,  and  in  some  heart  affections;  in  cases  of  defective 
blood  circulations  in  the  capillaries,  from  disease  of  the  heart,  especially 
if  there  is  fatty  degeneration;  from  defective  valvular  action,  from  depos- 
its on  them;  from  pericardiac  exudates;  from  the  action  of  poison  acting 
directly  on  the  heart;  or  from  some  injury  or  pressure  on  the  jugular;  in 


GENERAL  EXAMINATION  "  5 

diseases  where  there  is  a  great  accumulation  of  blood  in  the  head,  as  in 
acute  hypcrsemia  of  the  brain  and  inflammation  of  the  brain.  In  the 
latter  case  the  redness  of  the  mucous  membrane  is  lighter  in  color  or 
more  of  the  arterial  tint.  A  yellow  color  (icteric)  generally  denotes  some 
disorder  of  the  liver,  such  as  gastro-duodenal  catarrh,  causing  a  swelling 
and  obstruction  of  the  ductus  choledochus;  occasionally,  from  calcareous 
deposits  or  foreign  bodies  in  the  bile-ducts  or  the  presence  of  tumors  that 
press  on  the  bile-ducts.  In  rare  instances  these  yellowish  discolorations 
may  be  due  to  disturbances  of  the  liver  cells,  or  from  such  poisons  as 
phosphorus  and,  in  extremely  rare  cases,  from  mycotic  meat  poisoning 
and  infectious  diseases.  The  icterus  which  appears  in  phosphorus  poison- 
ing is  due  to  biliary  engorgements,  and  decomposition  of  the  blood. 
Various  spots  or  red  patches  known  as  petechial  spots  are  seen  on  the 
mucous  membranes  of  the  head.  These  are  a  valuable  aid  to  diagnose 
certain  internal  diseases,  such  as  phosphorus  poisoning,  scurvy,  meat 
poisoning,  and  in  septicaemia. 

The  nasal  and  buccal  discharges  are  treated  fully  under  the  head  of 
Examinations  of  the  Digestive  and  Respiratory  Apparatus.  We  will 
only  consider  here  such  discharges  from  the  eye  as  seen  in  very  sick 
animals  and  are  due  to  acute  febrile  disturbances.  In  some  cases  the  pad 
of  fat  that  fills  the  posterior  part  of  the  orbital  cavity  is  very  rapidly 
absorbed  and  the  eye  has  a  sunken  look;  the  fever  may  produce  an  irrita- 
tion of  the  mucous  glands  surrounding  the  eye  and  cause  the  accumula- 
tion of  a  profuse  mucous  discharge,  varying  in  color  from  gray  to  grayish- 
yellow,  seldom  pure  yellow.  This  accumulates  about  the  corners  of  the 
eyelids,  or  may  even  close  and  glue  up  the  eyelids  entirely;  this  is  not  a 
symptom  of  true  conjunctivitis,  but  some  acute  disorder  involving  the  en- 
tire system.     For  further  information  see  chapter  on  Diseases  of  the  Eye. 

SKIN  AND  SUBCUTANEOUS  MEMBRANE. 

The  skin  presents  a  number  of  conditions  which  are  diagnostic. 
Of  course,  there  are  a  number  of  local  diseases  of  the  skin  which  are 
treated  in  detail  in  section  on  Skin  Diseases.  The  skin-changes  in  color  are 
seen  mainly  on  the  belly  and  inner  fascia  of  the  thigh;  a  reddened  or 
slightly  yellow  color  is  to  be  classed  under  the  same  head  as  if  it  had  been 
present  on  the  mucous  membrane;  that  is,  if  the  skin  is  very  red  it  indi- 
cates a  high  temperature  or  the  commencement  of  some  sympathetic 
skin  eruption;  or  if  it  is  yellow  it  indicates  some  disturbance  of  the  liver  or 
portal  system.  In  cases  of  distemper  we  often  see  a  pustular  eruption  on 
the  abdomen  and  inner  fascia  of  the  thigh  (the  exanthema  of  distemper — 
dog-pox) ;  this  is  a  very  prominent  diagnostic  symptom  of  the  disease.  The 
skin  of  a  sick  dog  is  very  dry  and  hard,  it  is  very  hot  in  cases  of  intense 


I 


6  GENERAL  EXAMINATION 

fever,  and  cold  in  animals  that  are  very  much  debilitated,  or  after  severe 
external  or  internal  hemorrhage,  or  collapse  from  shock.  In  fat  dogs  the 
skin  has  a  very  unpleasant  greasy  feel  to  the  touch.  An  unfavoraljle 
symptom  of  disease  is  when  a  fold  of  the  skin  is  lifted  by  the  hand  and 
remains  in  the  same  position  when  released.  Profuse  perspiration  is 
rarely  seen  in  dogs  except  where  they  may  have  been  badly  frightened. 
Dogs  do  perspire  constantly,  but  it  is  insensible  perspiration. 

The  hair  is  also  a  useful  guide  in  diagnosis.  In  sick,  badly  fed,  or 
neglected  animals,  or  if  they  are  infested  with  parasites,  it  loses  its  gloss, 
becomes  dry  and  brittle,  breaking  easily,  and  in  some  cases  falls  out  par- 
tially or  entirely.  As  a  rule,  in  all  dogs  that  have  undergone  a  severe 
illness,  the  hair  falls  out  to  a  large  extent;  in  bitches  that  have  nursed  a 
large  litter  of  puppies,  the  hair  falls  out  in  large  Ciuantities  after  weaning. 


Fig.    1. — Dog  with  a?deina  of  the  skin.      +  marks  indentation  made  bj'  the  pressure  of  the  finger. 


The  odor  of  the  skin  is  sometimes  very  offensive,  especially  in  dogs 
suffering  with  distemper  and  septicaemia,  meat  poisoning,  infectious 
hemorrhagic  gastro-enteritis,  and  certain  skin  affections,  and  in  animals 
that  are  neglected  and  filthy. 

CEdema  and  emphysema  of  the  skin  are  very  important  diagnostic 
points.  By  oedema  or  dropsy  of  the  skin  (anasarca)  we  understand  it  to 
be  an  abnormal  accumulation  of  fluids  in  the  skin  and  the  subcutaneous 
cellular  tissues.  This  condition  is  caused  by  the  fluids  not  being  reabsorbed 
by  the  lymph  vessels  in  the  same  proportion  that  they  come  out  of  the 
blood  vessels.  We  recognize  oedema  by  a  swollen  or  bloated,  painless, 
cool  condition  of  the  skin,  with  the  obliteration  of  all  wrinkles;  if  the 
swelling  is  pressed  with  the  finger,  the  indentation  remains  visible  for 
sometime  (Fig.  1) ;  this  may  come  from  a  number  of  diseased  conditions, 
and  it  is  seen  sometimes  over  the  entire  body,  but  chiefly  in  the  lower 


GENERAL  EXAMIXATIOX  7 

portions  of  the  body  and  extremities,  testicles,  prepuce,  scrotum,  abdomen, 
and  chest.  It  occurs  as  a  complication  in  diseases  of  the  heart,  especially 
where  there  is  imperfect  valvular  action,  in  acute  and  chronic  disorders 
of  the  kidneys  and  cirrhosis  of  the  liver  and  in  the  majority  of  prolonged 
acute  affections.  In  rare  instances  it  is  caused  by  true  diseases  of  the 
blood — anaemia,  leukaemia,  and  pseudo-leukaemia,  abdominal  dropsy, 
hydro-thorax,  and  dropsy  of  the  pericardium. 

The  oedema  which  appears  in  the  locality  of  an  inflammation  (collat- 
eral cedema)  is  of  special  interest  to  the  surgeon,  as  it  is  the  only  visible 
symptom  of  the  inflammatory  process  that  is  going  on  under  the  skin. 
CEdema  may  be  also  seen  as  a  result  of  the  pressure  caused  by  tight  or 
improper  bandaging. 

Emphysema  of  the  skin  is  where  the  skin  looks  as  if  there  was  air  in 
the  subcutaneous  tissue.  As  a  rule  it  is  confined  to  small  circumscribed 
parts  of  the  body,  but  it  has  been  observed  by  the  author  where  the  whole 
body  has  been  involved.  There  is  an  intense  swelling  of  the  parts,  and 
on  pressure  with  the  finger  the  indentation,  unlike  oedema,  immediately 
disappears.  On  rubbing  over  the  parts  with  the  hand  a  slight  crackling 
sound  can  be  heard  and  felt;  on  pressure,  the  air  can  be  driven  from  the 
affected  portion  into  the  subcutaneous  or  other  tissues  beyond  the  border- 
line. This  condition  may  be  caused  by  the  admission  of  atmospheric  air 
from  the  outside  into  the  subcutaneous  tissues,  by  means  of  small  wounds 
in  the  skin,  especially  in  the  neck,  wall  of  the  chest,  and  the  head,  and  gas 
or  air  from  some  of  the  internal  organs  by  a  perforation  of  their  walls, 
such  as  the  larynx,  trachea,  oesophagus,  the  bowels,  or  stomach.  In 
cases  where  there  are  perforating  wounds  of  the  chest,  wounds  of  the 
larynx  or  windpipe,  or  from  fractures  of  the  ribs,  with  complicated  in- 
juries of  the  lungs.  Emphysema  may  also  occur  from  gas  formed  by 
breaking  down  the  contents  of  abscesses  or  hemorrhagic  infiltrations. 
In  malignant  abscesses,  we  find  the  swelling  is  doughy  and  painful,  the 
enlargement  becomes  crackly  and  septicaemia  develops. 

Increased  Temperature  of  the  Body. 

The  normal  temperature  of  the  dog  taken  at  the  rectum  differs  from 
37.5  C.  to  39;  as  a  rule,  younger  animals  have  a  higher  temperature  than 
adults.  The  normal  temperature  in  young  animals  is  generally  about 
39.2  and  39  in  older  animals.  The  vaginal  and  rectal  temperatures  are 
practically  the  same.  The  prepuce  temperature  is  about  1.5,  and  the 
skin  temperature  at  the  warmest  places  on  the  body  about  1°  lower  than 
the  rectal  temperature. 

The  author,  after  a  series  of  observations  covering  over  a  large  num- 
.  bcr  of  animals,  finds  the  above  to  be  correct  and  particularly  as  far  as  the 
prepuce,  vagina  and  skin  temperature  is  concerned. 


8  GENERAL  EXAMINATION 

The  following  averages  were  obtained  from  a  series  of  temperatures 
taken  from  both  normal  and  feverish  animals:  1,  in  the  bitch  the  average 
difference  between  the  rectum  and  vaginal  temperatures  was  about  0.06 
and  2,  in  the  male  the  difference  between  the  rectum  and  prepuce  was  1.43; 
some  cases  when  the  animal  became  nervous  or  excited,  when  the  pre- 
puce temperature  was  taken  and  the  penis  became  erected,  this  increased 
the  temperature  up  to  40,  so  that  it  will  be  seen  that  it  is  not  advisable 
to  take  the  temperature  from  the  prepuce,  as  the  difference  may  range 
from  2  to  3  degrees. 

The  average  difference  between  the  axilla  and  the  rectal  temper- 
ature is  0.93  and  between  the  inguinal  temperature  and  the  rectal  is 
0.81.  The  method  for  taking  these  temperatures  is  as  follows:  Place 
the  thermometer  in  the  so-called  axillary  groove  (arm-pit)  and  inguinal 
groove  (the  hollow  between  the  thigh  and  scrotum  in  males  and  between 
the  thigh  and  mammary  glands  in  the  bitch),  firmly  hold  the  ther- 
mometer for  five  minutes  so  that  the  mercury  end  of  the  thermometer  will 
be  covered  by  the  folds  of  the  skin.  Where  you  have  to  take  the  tem- 
perature in  these  two  localities  one  degree  should  be  added  to  the  therm- 
ometer reading.  As  a  rule  the  temperature  of  the  normal  animal  is  higher 
in  the  evening,  and  slightly  higher  after  a  hearty  meal,  violent  exercise, 
lying  in  the  sun  or  near  the  fire.  The  rectal  temperature,  so-called  body 
temperature,  is  taken  by  means  of  a  maximum  or  clinical  thermometer, 
the  thermometer  is  slightly  oiled,  or  the  anus  may  be  oiled  and  the 
thermometer  placed  as  far  as  possible  into  the  rectum  (allowing  a  small 
portion  of  the  instrument  to  protrude  to  facilitate  removal) ;  allow  it  to 
remain  for  at  least  five  minutes.  Hard  dry  pieces  of  excrement  or  a 
highly  inflammatory  condition  of  the  bowels  may  prevent  the  ther- 
mometer from  giving  the  exact  temperature  of  the  body.  In  severe  cases 
it  is  always  advisable  to  take  the  temperature  at  least  three  times  daily, 
morning,  noon  and  in  the  evening,  and  care  must  be  taken  to  carefully 
note  any  change  in  the  reading  of  the  thermometer.  The  temperature 
must  be  kept  on  a  temperature  chart,  and  can  be  watched  with  a  great 
deal  more  certainty  than  trusting  to  the  memory.  Any  change  in  the 
temperature  as  indicated  on  the  chart,  either  rise  or  fall,  indicates  some 
change  in  the  animal's  condition,  and  should  be  considered  a  symptom. 
As  soon  as  we  detect  an  increase  of  the  temperature  of  the  body  above 
the  normal  that  we  know  is  not  due  to  overheating  or  too  great  exertion, 
we  define  it  under  the  name  of  fever. 

The  course  and  severity  of  a  fever  are  regulated  according  to  the 
amount  and  character  of  the  fever-producing  substances  (pyrogenes), 
which  have  penetrated  into  the  blood-circulation.  In  some  cases  we  may 
have  a  rapid  increase  in  the  temperature  (fever-paroxysm) ;  this  is  often 
observed  in  the  early  stages  of  distemper  or  where  some  tissue  has  com- 


GENERAL  EXAMINATION  9 

menced  to  suppurate.  In  cases  where  the  temperature  remains  the  same 
it  is  called  a  continuous  fever,  and  if  it  does  not  change  more  than  1° 
(celsius)  it  is  known  as  a  remittent  fever;  but  when  it  is  found  that  it 
varies  greatly,  oscillating  between  a  very  low,  subnormal  and  a  very 
high  abnormal  temperature,  it  is  called  irregular  or  atypical  fever. 

A  constant  and  prolonged  high  temperature  is  very  rarely  seen  in 
the  dog.  The  temperature,  as  a  rule,  in  early  stages  of  all  acute  diseases 
rises  ver}^  quickly,  but  it  generally  falls  slowly  as  the  disease  advances, 
notwithstanding  the  complications,  and  may  reach  a  normal  or  frequently 
a  subnormal  condition.  In  cases  of  septicaemia,  which  is  rather  a  common 
disease  in  the  dog,  we  may  see  an  abrupt  lowering  of  the  temperature 
below  the  normal  and  continue  so,  the  animal  falling  into  a  state  of  coma 
and  death  follows  in  a  short  time. 

A  fever,  as  a  rule,  begins  with  a  chill  or  a  number  of  them;  this  is  a 
shivering  or  quivering  of  the  muscles  and  skin  and  finally  of  the  whole 
body.  These  chills  come  on  at  intervals.  The  rise  in  the  temperature  is 
not  always  an  accompaniment  of  the  fever,  as  has  been  shown  in  cases  of 
septicaemia;  we  must,  therefore,  always  take  into  consideration  the  other 
symptoms  of  fever.  These  are:  shivering,  cold,  increase  in  the  number 
of  the  pulse  and  respirations;  the  digestion  is  immediately  impaired  and  the 
urine  is  changed  in  quantity  and  composition.  All  the  secretions  and 
excretions  are  altered  from  the  normal  and  the  nerve-centres  show 
increased  irritability.  The  changes  in  the  pulse  and  respiration  are 
fully  described  under  the  head  of  Examination  of  the  Circulatory  Appara- 
tus. The  changes  in  digestion  are  seen  in  the  entire  loss  of  appetite,  con- 
stipation, and  increased  thirst.  The  kidneys  show  the  effects  of  the 
disturbance  by  the  decrease  in  the  amount  of  the  urine  secreted,  a  much 
higher  specific  gravity,  and  a  decreased  amount  of  the  chlorides  in  the 
urine,  an  increase  in  the  amount  of  urates,  and  a  high  acid  reaction.  In 
nursing  bitches  the  milk  is  much  lessened  in  quantity,  the  skin  becomes 
dry  and  firm,  and  the  sebaceous  glands  almost  cease  secreting.  The 
nerve-centres  show  the  effect  by  the  dulness  of  the  animal  and  the  indiffer- 
ence to  surrounding  objects  or  persons,  and  great  restlessness  and  twitch- 
ing of  the  muscles.  If  the  temperature  is  high,  the  animal  becomes 
weak  and  falls  away  in  weight  very  rapidly. 

A  Temperature  Below  Normal  (Subnormal)  of  the  Body. 

A  subnormal  temperature  is  often  observed  in  cases  where  the 
crisis  or  highest  temperature  has  passed  and  the  animal  is  going  on 
toward  recovery  or  convalescence.  In  the  majority  of  cases,  as  the 
temperature  goes  down  the  pulse  lessens,  the  respirations  become  even 
and  regular,  the  appetite  begins  to  return,  and  the  animal  shows  more 


10  GENERAL  EXAMINATION 

interest  in  its  surroundings.  In  collapse  there  is  a  rapid  fall  of  tempera- 
ture, and  the  heart's  action,  as  shown  by  the  pulse,  becomes  weak  and 
fluttering  and  soon  imperceptible;  the  mucous  membranes  are  pale,  and 
the  animal  weak  and  even  paralyzed.  There  is  also  a  subnormal  tempera- 
ture in  great  hemorrhage,  in  acute  and  chronic  diseases,  in  icterus  gravis 
(acute  congestion  of  the  liver,  with  yellowness  of  the  mucous  membranes), 
in  all  acute  diseases  of  the  brain,  in  various  cases  of  poisoning,  in  latter 
stages  of  distemper,  and  in  septicaemia,  in  infectious  hemorrhagic  gastro- 
enteritis. 

In  increase  or  decrease  of  the  local  temperature;  increased  heat  of  the 
part  is  generally  due  to  some  injury  or  some  surgical  disease,  and,  as  a  rule, 
has  with  it  tenderness  to  the  touch  and  swelling.  A  local  heat  can  also  be 
felt  in  all  inflammations  that  are  not  located  too  far  from  the  surface  of  the 
body.  Coldness  of  any  part  indicates  an  impaired  circulation  in  the  part. 
In  all  cases  of  collapse  the  extremities  are  the  first  to  become  cold,  because 
of  the  impaired  action  of  the  heart.  In  cases  of  compression  of  an  artery 
by  ligatures,  or  tumors,  pressing  on  the  blood  vessels,  an  embolus,  or 
thrombus,  the  part  of  the  body  that  has  thus  lost  its  circulation  becomes 
cold  from  impaired  circulation.  Paralyzed  extremities  are  always  slightly 
colder  to  the  touch  than  active  parts. 


DISEASES  OF  THE  DIGESTIVE  APPARATUS. 
EXAMINATION  OF  THE  DIGESTIVE  APPARATUS. 

In  making  an  examination  of  the  digestive  apparatus  we  have  to 
consider  the  following  points: 

The  appetite;  the  method  of  giving  the  food  in  different  animals 
varies  very  much,  also  is  influenced  to  a  large  extent  by  the  quality  of 
the  food,  the  way  in  which  it  is  presented  to  the  animal.  The  age,  the 
use  to  which  an  animal  is  put,  such  as  a  hunting  dog  or  the  laboring  dog 
of  Belgium  and  other  European  countries,  the  breed;  size  also  has  an 
influence  on  the  amount  of  food  eaten  by  the  animal  and  the  quantity  of 
water  it  drinks.  Some  animals  have  a  strong  appetite,  eat  large  quan- 
tities, digest  it  well,  whereas  others  are  dainty  eaters,  eat  small  quanti- 
ties, and  are  easily  satisfied. 

A  loss  of  appetite  may  result  from  a  number  of  causes;  mainly,  from 
the  presence  of  a  fever  in  the  system,  by  disorder  of  the  stomach  and 
digestive  apparatus,  lack  of  food,  cold,  chilliness,  poisons,  and  in  conse- 
quence of  such  diseases  as  distemper,  infectious  hemorrhagic  gastro- 
enteritis and  septicaemia.  An  abnormal  increase  of  the  appetite  may  be 
seen  in  diabetes  mellitus  and  by  the  presence  of  tape-worm.  A  depraved 
appetite  is  seen  in  rabies,  when  the  animal  will  eat  straw,  wood,  stone, 
I'ags,  and  faeces,  but  we  must  also  take  into  consideration  the  fact  that 
young  animals,  particularly  in  puppies,  when  they  are  teething,  between 
the  ages  of  four  and  ten  months,  will  pick  up  small  indigestible  objects, 
such  as  buttons,  pieces  of  tape,  muslin,  coal,  wood,  etc.  All  dogs,  par- 
ticularly if  the  stomach  is  upset,  will  eat  grass,  and  also  in  some  cases  they 
show  a  depraved  appetite  by  eating  horse  droppings  or  decayed  objects, 
and  the  well-known  habit  dogs  have  of  chewing  bones.  When  the  animal 
has  great  thirst,  drinking  large  quantities  of  water,  it  may  indicate 
diabetes  insipidus,  and  mellitus,  chronic  nephritis,  dropsy  (ascites),  or 
exudative  pleuritis.  As  a  result  of  acute  and  prolonged  diarrhoea, 
decayed  meat  poisoning,  catarrh  of  the  stomach  and  in  cases  of  irritation 
of  the  stomach,  the  animal  drinks  large  quantities  of  water  and  immedi- 
ately vomits  it  again. 

In  certain  diseases,  particularly  of  the  mouth  and  throat,  such  as 
irritations  of  the  mucous  membrane  of  the  mouth,  stomatitis,  decayed 

11 


12 


DISEASES  OF  THE  DIGESTIVE  APPARATUS 


teeth,  tumors  or  foreign  bodies  in  the  cavity  of  the  mouth,  raniila,  in 
di.seases  of  the  masseter  muscle,  buccal  membrane,  maxillo-temporal 
articulation,  the  animal  is  unable  to  eat  large  pieces  of  food,  taking  only 
small  finely  cut-up  food  or  liquids. 

Difficulty  in  swallowing  may  be  present  in  all  the  conditions  already 
mentioned  and  in  some  cases  the  animal  will  drop  the  food  out  of  the 
mouth  after  it  has  taken  it  up.     Inability  to  swallow  may  be  seen  in 


Fig.  2. — Larj'ngoscope. 


inflammation  of  the  pharynx  and  larynx,  in  the  paralytic  stage  of  rabies, 
as  the  result  of  certain  poisons,  such  as  meat  poisons,  in  periods  of  brain 
disease,  injury  to  the  mouth  and  throat,  tumors  or  foreign  bodies  in  the 
throat  or  larynx,  contraction  or  ossification  of  the  larynx,  in  tetanus, 
large  swelling  in  the  region  of  the  neck  and  goitre. 


^m 


Fig.  3. — Pocket  electric  light. 


Condition  of  the  Mouth  and  Throat. 


The  examination  of  these  parts  requires  a  good  light  such  as  day- 
light, or  a  clear  lamp  when  the  posterior  part  of  the  throat  has  to  be 
examined.  This  can  be  accomplished  by  means  of  a  perforated  laryn- 
geal mirror  or  any  reflecting  mirror  (Fig.  2),  or  a  portable  electric 
lamp  (Fig.  3).  The  best  method  of  opening  the  mouth  with  the  hands  is 
to  grasp  the  upper  jaw  with  one  hand,  pressing  the  cheeks  between  the 
teeth,  which  forces  the  mouth  partially  open  and  prevents  the  animal 
closing  the  mouth,  and  with  the  other  hand  pull  down  the  lower  jaw. 
Another  method  to  obtain  a  good  view  of  the  interior  of  the  mouth  is  to 
put  two  strings  or  tapes  around  the  lower  and  upper  jaws  (Fig.  4) ;  lay  the 


EXAMINATION  OF  THE  DIGESTIVE  APPARATUS  13 

dog  on  his  side  or,  what  is  better,  directly  on  his  back  and  throw  the  light 
into  the  cavity  of  the  mouth.  The  mouth  and  a  large  part  of  the  throat 
can  then  be  easily  examined.  In  nervous  or  uneasy  animals  we  can 
use  a  speculum  (Fig.  5)  or  a  gag  if  the  mouth  has  to  be  kept  open  for 
some  time;  it  is  best  to  use  a  gag  which  can  be  placed  between  the  teeth 
on  one  side,  or  by  means  of  a  wedge-shaped  piece  of  wood.     In  certain 


Fig.  4. — Holding  the  mouth  open  with  tapes. 

operations  of  the  interior  of  the  mouth  and  teeth  a  wooden  bar  held  in 
place  by  means  of  a  chain  is  used  (Fig.  6).  When  the  deeper  portions 
of  the  mouth  and  throat  are  to  be  examined  the  mouth  is  opened,  and  by 
means  of  the  finger,  a  spatula,  or  the  handle  of  a  spoon,  the  tongue  is 
depressed.  A  good  view  of  the  posterior  of  the  throat  can  be  obtained  by 
grasping  the  tongue  with  forceps  and  pulling  it  forward. 

In  cases  where  the  mouth  remains  partially  open,  the  animal  being 
unable  to  close  it,  we  must  examine  it  very  carefully,  as  it  may  be  a 
symptom  of  rabies;  of  some  brain  disease;  secondai'y  stages  of  distemper; 
in  some  bacterial  poisons,  severe  injury  of  the  mouth  or  in  fracture  of  the 


14 


DISEASES  OF  THE  DIGESTIVE  APPARATUS 


inferior  maxillary.  It  may  also  be  due  to  some  foreign  bodies  located 
between  the  teeth  or  some  strain  of  the  articulation  of  the  inferior  maxil- 
lary.    In  paralysis  of  the  jaw,  the  mouth  can  be  closed  by  putting  a  stick 


Fig.  5. — Mouth  speculum. 


under  the  jaw  and  lifting  it;  this  cannot  be  done  in  cases  of  luxation  of 
the  articulation  or  where  there  is  some  foreign  body  between  the  teeth, 
such  as  bones  or  pieces  of  wood.  The  mouth  cannot  be  opened  com- 
pletely in  trismus  (tetanus)  or  in  partial  anchylosis  of  the  articulation;  the 


Mjig^ 


Fig.  6.— Gag. 


introduction  of  the  speculum  being  very  painful  in  some  cases  of  tooth- 
ache. In  injuries  of  the  various  masticating  muscles,  disease  of  the  ar- 
ticulation of  the  jaw  and  infectious  hemorrhagic  gastro-enteritis.  If  the 
speculum  iy  introduced  frequently,  the  mouth  may  remain  partially  open. 


EXAMINATION  OF  THE  DIGESTIVE  APPARATUS  15 

On  opening  the  mouth,  if  there  is  a  very  offensive  odor  coming  from  it,  it 
indicates  either  an  ulceration  of  the  mouth,  due  to  ulcerative  stomatitis, 
which  has  erroneously  been  called  scurvy,  disease  of  the  teeth  and  in  cer- 
tain diseases  of  the  stomach,  in  dyspepsia,  foetid  bronchitis,  or  in  gan- 
grene of  the  lungs;  it  is  frequently  noticed  in  animals  which  are  very  sick, 
where  the  mouth  is  filled  with  unhealthy  mucus  or  where  particles  of 
food  lie  in  the  mouth  or  throat.  In  infectious  hemorrhagic  gastro- 
enteritis, a  very  offensive  odor  is  noticed.  In  cases  of  poisoning,  by 
phosphorus,  or  prussic  acid,  the  odor  of  the  drug  is  frequently  detected  in 
the  breath.  On  examining  the  teeth  and  gums  we  may  see  large  ossific 
deposits  of  the  alveolar  process  (dental  alveolar  periostitis)  causing  sepa- 
ration of  the  gums  and  loosening  of  the  teeth.  An  intensely  inflamed 
state  of  the  gums,  where  they  are  bleeding  and  ulcerated,  indicates 
ulcerative  stomatitis,  mercurial  poisoning,  or  scurvy;  very  often  tumors 
(epulides)  are  found  on  the  inner  border  of  the  incisors  and  interfere 
more  or  less  with  eating.  Very  frequently  foreign  bodies  lie  between  the 
teeth,  causing  increased  flow  of  saliva.  The  cutting  of  the  milk  (tempo- 
rary) teeth  and  a  change  of  dentition  (cutting  of  the  permanent  teeth) 
may  cause  intense  inflammation  of  the  entire  mouth.  The  tongue  is 
examined;  it  may  appear  dry,  paralyzed,  and  in  some  cases  shrunken  and 
lie  on  the  floor  of  the  cavity  of  the  mouth;  from  paralysis  of  the  tongue  as 
a  result  of  distemper,  disease  of  the  brain,  or  infectious  hemorrhagic  gas- 
tro-enteritis.  The  author  has  noticed  paralysis  of  the  tongue  in  acute 
convulsions.  The  tongue  may  be  greatly  swollen  and  enlarged  in  acute 
inflammation  of  the  mouth,  or  from  parenchymatous  inflammation  of 
the  tongue.  Foreign  bodies,  such  as  needles  or  sharp  objects  may  pene- 
trate the  tongue.  Sometimes  wounds  and  scars  may  be  noticed  on  the 
edges  of  the  tongue  in  dogs  suffering  from  paralysis  of  the  masseter  muscle 
and  by  biting  the  tongue  when  the  animal  is  in  a  convulsion.  The  color 
of  the  tongue  is  a  deeper  red  from  fevers,  inflamed  conditions  of  the  mouth , 
and  certain  heart  affections.  A  cyanotic  (reddish-blue  color)  is  seen 
when  the  animal  is  partially  suffocated.  The  tongue  is  coated  as  a  result 
of  most  fevers,  but  it  is  also  observed  in  animals  which  are  perfectly 
healthy.  A  heavy  coating  of  the  tongue  is  noticed  in  stomatitis,  gastric 
catarrh,  and  in  acute  internal  diseases;  also  in  acute  cases  of  distemper. 
In  infectious  hemorrhagic  gastro-enteritis,  the  tongue  is  frequently 
covered  with  a  dirty-brown  coating.  As  a  rule,  a  paralyzed  tongue  lies  on 
the  floor  of  the  cavity  of  the  mouth.  In  gangrene  of  the  tongue  that 
organ  is  swollen  bluish-gray.  The  tip  of  the  tongue  may  sometimes  be 
bluish-black,  caused  by  being  bitten  or  being  maliciously  tied  with  a 
string.  A  bluish-red  discoloration  around  the  edge  of  the  tongue  may 
be  due  to  distemper,  stomatitis,  infectious  hemorrhagic  gastro-enteritis 
and  various  other  causes. 


16  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

After  administration  of  violent  poisons  the  mucous  membranes  of 
the  cheeks  and  inferior  surface  of  the  tongue  are  found  to  be  gray  in 
color,  hanging  in  shreds,  and  intensely  inflamed,  and  later  abscesses  form 
on  the  sloughed  parts.  This  is  observed  in  infectious  hemorrhagic  gastro- 
enteritis, stomatitis,  and  distemper,  as  a  result  of  decayed  teeth  and 
formation  of  abscesses  on  the  mucous  membrane  of  the  cheeks.  Ranula 
appears  on  the  floor  of  the  mouth-cavity  on  one  side  of  the  tongue;  it  is 
long  and  oval,  sometimes  the  shape  of  a  goose  egg;  the  sac  is  a  fluctuating 
swelling  with  a  thin  wall.  Small  whitish  enlargements  resembling  warts 
frequently  appear  on  the  mucous  membrane  of  young  dogs.  They  are, 
however,  of  little  or  no  importance.  The  salivary  glands  are  frequently 
swollen  and  abscesses  form  in  their  structure.  As  a  result  of  these  irrita- 
tions we  may  have  colloid  infiltration  of  the  glands,  and  after 
inflammation,  they  become  indurated,  the  secretion  of  saliva  is  some- 
times greatly  increased  and  runs  out  of  the  mouth  in  long,  thready 
strings;  this  is  also  seen  in  all  inflammatory  conditions  of  the  mouth  or 
where  there  is  an  abscess  located  in  the  mouth  or  throat  during  teething; 
in  cases  of  mercurial  poisoning,  and  from  some  caustic  poisons,  and 
after  the  hypodermic  injection  of  pilocarpine.  From  inflammation  of  the 
pharynx,  rabies,  and  by  certain  parasites  burrowing  through  the  tissues 
of  the  body. 

The  secretion  of  saliva  is  lessened  during  all  fevers,  and  from  the 
effects  of  some  poisons,  fevers,  diarrhoea,  and  after  the  injections  of 
atropia. 

The  saliva  is  bloody  after  injuries  of  the  mouth.  It  may  be  slightly 
stained  with  blood  from  stomatitis,  scurvy,  infectious  hemorrhagic  gastro- 
enteritis, and  gangrene  of  the  tongue.  The  soft  palate  and  pharynx  are 
sometimes  the  seat  of  acute  or  chronic  inflammations,  and  sometimes  we 
find  abscesses  of  these  parts  from  the  presence  of  foreign  bodies  (needles, 
splinters  of  bone  or  wood) .  It  is  well  to  feel  these  parts  when  making  an 
examination.  The  tonsils  are  affected,  as  a  rule,  in  all  cases  of  pharyn- 
gitis. It  generally  protrudes  from  the  side  of  the  base  of  the  tongue  in  a 
dark-red,  sausage-like  formation.  The  subparotid  lymphatics  are  invari- 
ably found  to  be  swollen,  in  all  cases  of  inflammation  of  the  pharynx. 

Examination  of  the  (Esophagus. 

The  oesophagus  protrudes  from  the  pharynx  on  a  level  with  the 
first  cervical  vertebra.  The  anterior  part  of  it  lies  between  the  wind- 
pipe and  the  longus  colli  in  the  median  line  of  the  neck.  It  extends  from 
there  to  the  left  side  of  the  windpipe  and  passes  to  the  right  side  of  the 
aortic  arch  between  both  membranes  of  the  mediastinum,  in  the  shape 
of  a  flat  arch,  and  perforates  the  diaphragm  at  the  twelfth  dorsal  vertebra 


EXAMINATION  OF  THE  DIGESTIVE  APPARATUS  17 

and  reaches  the  stomach  at  the  left  side.  The  width  of  the  oesophagus  is 
not  regular  in  its  entire  length,  being  narrower  at  the  region  of  the  pharynx 
and  at  the  cardiac  and  just  before  it  unites  with  the  stomach. 

The  oesophagus  is  examined  externally  by  the  hand  (palpation), 
or  internally  by  the  pharyngeal  sound  or  probang,  and  we  may  find  trau- 
matisms, tumors,  foreign  bodies  (pieces  of  bone,  wood,  large  pieces  of  food) 
which  become  lodged  in  the  oesophagus  generally  just  beyond  the 
pharynx  in  the  region  of  the  neck,  where  they  can  be  easily  felt  by  the 
hand.  The  thyroid  gland  is  sometimes  enlarged  from  local  inflamma- 
tion, struma,  or  carcinoma  and  care  must  be  taken  not  to  mistake  this 
for  a  foreign  body.  Very  frequently  we  find  the  lymphatics  of  this  region 
are  enlarged.  Carcinomas  or  sarcomas  are  sometimes  found  along  the 
course  of  the  oesophagus. 

The  introduction  of  the  laryngeal  probang  is  comparatively  easy 
in  the  dog.  The  best  probang  is  one  less  than  the  size  of  the  little  finger 
and  it  must  not  be  too  flexible,  the  length  should  be  from  20  to  30  cm.; 
this  size,  of  course,  is  for  the  ordinary  sized  dog;  in  very  small  animals 
the  ordinary  sized  urethral  catheter  can  be  used.  Care  must  be  taken 
to  have  the  probang  perfectly  smooth  and  uniform  in  diameter.  If  the 
probang  is  very  stiff  it  may  be  made  more  flexible  by  rubbing  it  briskly 
with  a  towel  or  putting  it  in  warm  water  for  a  few  seconds.  The 
method  of  introducing  the  probang  is  as  follows:  The  mouth  is  held  open 
as  described  on  page  12;  the  head  is  extended  and  it  is  introduced  along 
the  upper  wall  of  the  throat,  keeping  it  high  up  so  as  to  avoid  the  larynx. 
If  the  probang  should  slide  into  the  trachea  instead  of  the  oesophagus  and 
cause  dsypnoea,  the  instrument  must  be  instantly  withdrawn.  The 
animal  will  attempt  to  swallow  it,  but  that  will  assist  the  sounds.  It  will 
glide  along  easily  until  the  obstruction  is  reached,  or  glide  directly  into 
the  stomach.  In  cases  where  there  is  a  foreign  body  in  the  oesophagus  the 
probang  will  come  against  it,  preventing  the  instrument  going  any 
farther.  Great  care  must  be  taken  at  this  juncture  not  to  push  the  pro- 
bang  too  hard  as  it  may  lacerate  the  walls  of  the  oesophagus,  particularly 
if  there  is  a  stricture  or  a  tumor;  or  if  it  is  a  foreign  body,  it  may  cause  it 
to  be  more  firmly  imbedded  or  the  probang  may  rupture  (perforate)  the 
w^alls  of  the  oesophagus. 

Examination  of  the  Stomach. 

Baum,  who  has  made  a  careful  study  of  the  position  of  the  dog's 
stomach,  finds  when  the  stomach  is  filled  with  food,  its  outlines  can  be 
easily  recognized  by  palpation  (Fig.  7).  It  lies  in  the  left  side  of  the 
abdominal  cavity,  the  inferior  portion  resting  on  the  liver  and  the  ante- 
rior portion  against  the  diaphragm,  the  left  surface  going  toward  the 
2 


18 


DISEASES  OF  THE  DIGESTIVE  APPARATUS 


abdominal  wall,  but  between  that  and  the  wall  lies  the  left  lobe  of  the 
liver.  This  left  lobe  extends  as  far  as  the  pelvis,  coming  close  to  the  left 
kidney;  the  left  or  cardiac  end  of  the  stomach  extends  as  far  as  the  ninth 
rib  and  posteriorly  as  far  as  the  thirteenth  rib  and  the  anterior  border  of 
the  left  kidney.  The  right  or  pyloric  end  of  the  stomach  is  directed  on 
the  median  line  to  the  right.  The  larger  part  of  the  stomach  is  enclosed 
by  the  liver  and  the  diaphragm  coming  in  contact  with  the  anterior  side. 
The  cardiac  end  of  the  stomach  is  directed  toward  the  median  line  and 
the  pyloric  toward  the  right.  The  empty  stomach  (Fig.  8)  extends 
anteriorly  as  far  as  the  left  pillar  of  the  diaphragm  and  toward  the  chest 
as  far  forward  as  the  tenth  rib  and  posteriorly  as  far  as  the  twelfth  rib, 


Fig.  7. — Section  through  centre  of  abdomen. 

and  is  completely  covered  by  the  liver  on  the  left  side.  Only  a  very  small 
part  of  it  comes  in  contact  with  the  diaphragm  and  the  inferior  face  of  the 
ninth  and  tenth  dorsal  vertebra.  The  pyloric  opening  is  directed  toward 
the  right  and  very  slightly  forward  (Fig  9).  When  the  stomach  is 
very  much  distended  with  gas  or  food,  it  comes  almost  directly  in  contact 
with  the  abdominal  walls,  and  when  greatly  distended  it  extends  as  far  as 
the  umbilical  region  and  lies  against  the  ribs  and  the  left  abdominal  wall 
and  the  left  and  ventral  lobes  of  the  liver  being  pushed  almost  entirely 
away  from  the  surface  of  the  stomach,  depending  on  the  amount  of  the 
distention. 

From  the  above  anatomical  details  it  can  be  readily  seen  that  it  is 
nearly  impossible  to  make  a  reliable  examination  of  the  stomach  when  it 
is  empty  or  even  when  it  is  fairly  well  distended.     The  cardiac  and  pyloric 


EXAMINATION  OF  THE  DIGESTIVE  APPARATUS 


19 


openings  are  so  deeply  seated  they  are  extremely  hard  to  examine.     To 
make  a  manual  examination  of  the  stomach,  the  animal  nmst  be  placed 


Fig.  8. — Position  of  stomach  when  empty. 


in  a  standing  position  or  sitting  in  the  favorite  position  of  the  dog,  that  is, 
resting  on  the  hind  legs.  The  finger  is  pressed  into  the  abdomen  back  of 
the  xiphoid  cartilage  or  on  the  right  side  beneath  the  cartilaginous  ends  of 


Dorsal  vertebrae. 


Lumbar  vertebrae. 


Fig.  9. — Position  of  stomach  when  full. 


the  ribs;  the  digital  pressure  at  first  may  be  gentle,  but  this  can  be  in- 
creased until  the  stomach  is  outlined. 

When  a  very  careful  examination  has  to  be  made  to  detect  the 


20 


DISEASES  OF  THE  DIGESTIVE  APPARATUS 


presence  of  foreign  bodies  or  tumors  in  the  stomach,  the  author  proceeds 
in  the  following  manner:  Place  the  dog  on  his  back  and  if  difficult  to 
handle,  or  vicious,  narcotize  it,  and  press  the  fingers  on  the  abdominal 
walls;  at  the  same  time  an  assistant  can  bring  the  front  and  hind  legs 
together,  bending  the  spine  as  much  as  possible.  This  position  relaxes 
the  abdominal  muscles  and  the  stomach  can  be  easily  outlined  and  its  size 
felt.  A  distended  or  engorged  stomach  can  be  recog- 
nized by  palpation  or  when  the  abdominal  walls  are 
relaxed  the  stomach  can  be  easily  detected  lying  in 
the  umbilical  region  and  extending  under  the  false 
ribs.  If  the  distention  is  due  to  gas  it  can  easily  be 
recognized  by  the  tympanitic  sound  on  percussion;  if 
the  distention  is  due  to  the  presence  of  some  fluid  it 
will  be  indicated  by  fluctuation.  Great  distention 
of  the  stomach  by  gas  is  found  as  a  result  of  certain 
poisons,  stenosis  of  the  bowels  and  in  alteration  of 
the  normal  position  of  the  stomach.  Great  ac- 
cumulation of  gas  is  seen  in  the  stomach  in  gastric 
catarrh,  but  it  may  also  be  present  in  an  entirely 
healthy  stomach.  The  contents  of  the  stomach  may 
feel  soft  or  doughy  according  to  the  quality  of  the 
food,  and  how  it  was  prepared,  w^hen  eaten.  The 
normal  condition  of  the  stomach  after  eating  is  that 
of  slight  distention.  Pyloric  stenosis  may  also  cause 
distention  of  the  stomach.  Tumors  on  the  wall  of 
the  stomach  are  extremely  difficult  to  diagnose,  ex- 
cept perhaps  in  small  animals  where  the  tissues  are 
more  elastic  and  less  dense.  Foreign  bodies  of  mod- 
erate size  and  of  some  dense  structure  can  be  felt  in 
the  stomach,  by  manipidation.  Certain  foreign 
bodies,  such  as  needles,  stones,  etc.,  can  be  detected 
in  the  stomach  by  means  of  Rontgen  or  X-rays  (see  description  of  foreign 
bodies  in  the  stomach) .  Pain  on  pressure  of  the  stomach  may  be  produced 
by  manipulation,  but  it  is  not  always  present;  it  may  be  noticed  in  acute 
gastric  catarrh,  toxic  gastritis,  infectious  hemorrhagic  gastro-enteritis. 
It  must  be  remembered,  however,  that  it  is  only  the  filled  or  distended 
stomach  that  can  be  felt,  due  to  the  lobe  of  the  liver  lying  between  the 
stomach  and  the  abdominal  wall  and  pain  on  pressure  may  indicate  some 
disorder  of  the  liver  and  not  of  the  stomach.  Consequently,  in  making  a 
diagnosis  we  must  include  other  observations,  particularly  an  examination 
of  the  contents  of  the  stomach. 

We  can  obtain  the  contents  of  the  stomach  either  by  the  substance 
which   the    animal    may    vomit    itself    or   by   means    of    the    stomach- 


FiG.  10. — Stomach-pump. 


EXAMINATION  OF  THE  DIGESTIVE  APPARATUS 


21 


pump.     This  has  been  recommended  by  Frick,  and  only  for  therapeutic 
purposes. 

The  stomach-pump  is  operated  in  the  following  manner:  In  large 
dogs  an  ordinary  horse  catheter  is  used  and  in  small  dogs  a  large  male 
human  catheter  or  a  small  rubber  hose.  We  pass  the  catheter,  as  de- 
scribed in  the  examination  of  the  cesophagus,  into  the  stomach  and  to  the 
free  end  of  the  catheter  or  rubber  hose,  which'  should  be  about  30  cm. 
long,  we  put  a  small  funnel  at  the  other  end  of  the  tube  (Fig.  10).  Pour 
a  certain  amount  of  water  into  the  stomach  through  the  tube,  at  the 
same  time  holding  the  tube  high,  and  then  manipulate  the  region  of  the 
stomach  and  next  depress  the  tube,  and  the  siphon  which  has  been  formed 
will  soon  empty  the  stomach  of  its  contents.     This  method  is  to  be  used 


Fig.    11. 


-Contents  of  the  stomach  (four  hours  after  eating) :     Muscular  fibre,  starch  cells,  fat  cr>-stals 
and  cells,  round  cells,  epithelium,  vegetable  cells,  fungus. 


in  very  urgent  cases  where  poison  is  suspected,  but  as  a  rule  is  very  hard 
to  do  except  in  very  quiet  animals  and  where  there  is  a  trained  assistant, 
such  as  in  a  hospital;  but  in  private  practice  the  easier  wa}-  is  the  better, 
that  is,  to  administer  an  emetic.  The  best  means  is  to  give  a  dose  of 
apomorphia  hypodermatically. 

I^       .\pomorphia  hydrochlorate,  0.04 

Aqua  distil.,  4.00 

Sig. — Ten  to  twenty  drops  hypodermatically. 


In  a  few  minutes  free  vomiting  occurs  and  the  contents  of  the  stomach 
can  then  be  examined.  Of  course,  you  must  take  into  consideration 
the  time  which  has  elapsed  since  the  animal  has  taken  the  food  and  the 
character  of  the  alimentary  matter.  It  would  be  well,  therefore,  that 
you  know  the  following  facts  concerning  (Fig.  11)  digestion  in  the  dog's 
stomach: 


22  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

Digestion  of  a  Meat  Diet  in  the  Stomach. 

After  taking  a  full  meal  of  meat  cut  in  small  pieces  the  digestion 
in  the  stomach  is  veiy  active  and  free;  it  increases  until  the  third  hour 
antl  slowly  decreases  until  the  ninth,  and  is  nearly  over  at  the  twelfth 
hour.  After  eating  a  very  large  meal  the  digestion  is  somewhat  slower 
and  lasts  considerably  longer,  the  different  kinds  of  meat  also  vary  in  the 
t  ime  of  their  digestion.  Pork  is  the  easiest  to  digest  and  others  are  classified 
in  the  following  order:  mutton,  veal,  beef,  and  lastly  the  flesh  of  other 
animals  (Astley  Cooper) ;  skin,  tendon,  sinew,  cartilage,  and  bones  are 
very  hard  to  digest;  the  latter  are  digested  from  their  surface  and  are 
reduced  as  the  gelatinous  parts  are  acted  upon  and  dissolved  and  the 
lime  salts  remain  unchanged.  Fat  meat  is  harder  to  digest  than  lean; 
fat  undergoes  no  change  in  the  stomach,  but  passes  on  and  is  digested 
in  the  intestines.  The  gastric  juice  acts  on  and  reduces  roasted  meats 
and  if  raw  meat  is  chopped  up  in  small  pieces  the  gastric  juice  acts  on  it 
much  more  quickly.  It  has  never  been  satisfactorily  settled  whether  raw 
or  cooked  meat  is  easier  to  digest. 

The  Digestion  of  Milk  in  the  Stomach. 

Milk  is  comparatively  slow  in  digestion.  After  an  animal  had  taken 
249  grammes  of  milk  he  was  destroj^ed  four  hours  later  and  13  grammes 
of  cheese  and  1  gramme  of  fluid  was  found  in  his  stomach. 

Action  of  Digestion  on  Hydrocarbonaceous  Food. 

Five  hours  after  a  meal  consisting  of  rice  and  potatoes  the  mass  was 
liquefied  and  softened;  the  mashed  portion  of  the  potatoes  had  disappeared 
but  the  lumps  remained.  After  a  meal  of  rice,  the  following  observations 
were  made:  After  one  hour  10  per  cent,  was  digested,  after  two  hours 
25  per  cent.,  after  three  hours  50  per  cent.,  after  four  hours  82  per  cent., 
after  six  hours  90  per  cent.,  after  eight  hours  99  per  cent.,  and  at  the  end 
of  ten  hours  it  had  entirely  disappeared  (V.  Hofmeister). 

Both  Ellcnberger  and  Hofmeister  have  come  to  the  conclusion  that 
rice  is  chiefly  digested  in  the  intestines,  as  there  is  so  much  muriatic 
(hydrochloric)  acid  in  the  stomach  immediately  after  eating  that  sac- 
charation  cannot  take  place;  and  also  that  the  dog  swallows  his  food  with 
so  little  mastication  that  the  saliva  has  no  time  to  make  any  change  in 
the  starch. 

The  effect  of  the  disturbance  of  gastric  secretion  on  digestion  is 
as  follows:  When,  from  any  cause,  the  secretion  of  gastric  juice  is  les- 
sened or  altered  the  following  changes  are  observed:  The  digestion 
of  albumin,  and  the  antiseptic  and  antizymotic  action  of  the  gastric 


EXAMINATION  OF  THE  DIGESTIVE  APPARATUS  23 

juice  is  much  lessened,  for  there  is  no  doubt  that  gastric  juice  can  destroy 
the  infectious  bacteria  that  are  carried  into  the  stomach  by  the  food; 
consequently,  the  secretion  thus  being  much  less  acid,  with  the  lessened 
digestion  of  albvimen,  fermentation  is  easily  started.  When  the  gastric 
secretion  is  subacid  it  irritates  the  mucous  membranes  of  the  intestines 
and  lessens  the  peristaltic  action.  Subacidity  is  frequently  seen  in  all 
anaemic  diseases,  in  fevers,  in  erosion  of  the  mucous  membranes,  from 
the  effects  of  corrosive  poisons,  in  cancer  of  the  stomach,  and  in  chronic 
catarrh  of  that  organ. 

The  digestion  of  starch  is  impaired  by  an  oversecretion  of  hydro- 
chloric acid;  this  condition,  according  to  the  researches  of  Ellenberger 
and  Hofmeister,  is  not  of  great  importance,  although  in  man  it  is  fre- 
quently seen  in  ulceration  and  in  acute  and  chronic  catarrh  of  the 
stomach.  "Nervous  dyspepsia,"  so  common  in  man,  does  not  seem 
to  occur  in  the  dog. 

In  testing  the  contents  of  the  stomach  for  free  hydrochloric  acid  the 
best  reagent  is  red  paper  and  phloroglucin-vanillin  solution.  Moisten 
a  small  piece  of  this  paper  with  a  few  drops  of  the  filtered  fluid-contents  of 
the  stomach.  If  free  acid  is  present  the  red  color  of  the  paper  will  turn 
blue.  This  reaction  may  also  occur  if  lactic  acid  is  present.  This, 
however,  is  rarely  present  in  the  contents  of  the  stomach.  In  testing 
with  phloroglucin  (vanillin)  place  a  few  drops  of  the  following  solution: 
PhloroglucinS  parts;  vanillin  1  part;  alcohol  30  parts;  with  equal  quantity 
of  the  filtered  fluid  of  the  stomach.  Put  in  a  porcelain  dish  and  heat  but 
do  not  luring  to  a  boil.  If  there  is  free  hydrochloric  acid  present,  it  will 
produce  a  dark  red  precipitate;  if  it  is  present  in  a  small  amount,  the  pre- 
cipitate will  be  l^right  red;  if  the  acid  is  not  present,  the  precipitate  will 
be  brown  or  reddish-brown.  If  methyl-violet  solution  is  used,  if  a  trace  of 
free  acid  is  present,  it  will  color  the  solution  sky-blue.  The  test  is  made 
in  the  following  manner:  Make  a  certain  quantity  of  the  solution,  di- 
luting the  water  until  it  is  light  violet.  Divide  this  into  equal  parts  put- 
ting into  two  test-tubes.  To  one  of  the  tubes  add  a  few  drops  of  the 
filtered  gastric  fluid  and  if  any  free  acid  is  present,  the  solution  changes 
to  sky  blue  and  by  comparison  with  the  other  tube  the  amount  of  free 
acid  can  be  approximated,  being  guided  by  the  change  in  the  color. 

Testing  with  lactic  acid  is  much  easier  and  more  certain.  The  best 
method  is  that  of  Uffelman:  100  grammes  of  a  2  per  cent,  solution  of 
carbolic  acid  are  to  be  mixed  with  one  drop  of  chloride  of  iron  solution, 
which  makes  the  mixture  deep  blue;  if  a  few  drops  of  the  filtered  contents 
of  the  stomach  are  added  and  muriatic  acid  only  is  present,  it  becomes 
clear  as  water;  if  lactic  acid  is  also  present,  it  becomes  greenish-yellow 
in  color. 

In  summing  up  the  preceding  investigations  it  is  readily  seen  that 


24  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

the  stomach  may  not  be  digesting  all  that  the  animal  eats,  but  still  the 
animal  be  in  fairly  good  health;  while,  of  course,  it  must  also  be  under- 
stood that  in  fevers  or  any  general  disturbance,  the  digestive  powers  are 
greatly  impaired. 

Albumin  is  almost  entirely  digested  in  the  intestines,  the  stomach 
merely  preparing  it;  fat  and  starch  are  digested  only  in  the  small  intes- 
tines; muscular  tissue  must  have  a  previous  preparation  in  the  stomach, 
or,  if  it  reaches  the  small  intestines  without  becoming  saturated  with 
gastric  juice,  it  is  not  digested  in  the  intestines.  No  digestion  whatever 
takes  place  in  the  large  intestines. 

No  animal  vomits  more  easily  than  the  dog,  and  it  may  be  produced 
from  a  number  of  causes,  as  a  reflex  irritation  of  the  stomach,  viz., 

1.  By  irritation  of  the  mucous  membranes  of  that  organ  by  emet- 
ics, posions,  splinters  of  bone,  or  even  by  overloading.  Vomiting 
frequently  is  caused  by  the  animal  eating  grass. 

2.  By  sympathetic  irritation  from  other  organs,  intestinal  parasites, 
uraemia,  peritonitis,  irritation  of  the  intestines,  or  uterine  inflammations. 

3.  Vomiting  may  result  from  serious  coughing  spells,  as  a  result  of 
laryngitis,  l^ronchitis,  or  liquids  getting  into  the  larynx. 

4.  In  obstruction  of  the  bowels,  foreign  bodies  blocking  up  the  bowel, 
hernia  or  twisting  of  the  intestines.  In  some  cases  of  the  latter  con- 
dition excrement  is  vomited. 

5.  In  the  early  stages  of  distemper  and  infectious  hemorrhagic  gas- 
tro-enteritis,  persistent  vomiting  is  almost  invariably  present. 

6.  From  various  brain-affections  (meningitis,  commotio  cerebri). 
Very  often  in  certain  diseases  of  the  pharynx  and  where  foreign  bodies 
have  become  imljedded  or  fixed  about  the  root  of  the  tongue,  pharynx 
or  oesophagus  and  in  pharyngitis,  movements  of  the  throat  resembling- 
vomiting  are  frequently  noticed. 

The  amount  of  vomited  matter  depends  to  a  certain  extent  on  the 
density  of  the  material  in  the  stomach,  what  it  is  composed  of,  and  the 
cfuantity  present  in  the  stomach  at  the  time  of  the  vomiting.  In  cases 
where  the  animal  vomits,  when  the  stomach  is  full,  the  vomited  material 
will  either  be  the  food  in  a  uniform  pulpy  mass,  or  the  mass  may  be 
largely  fluid,  with  the  food  lying  in  it,  with  little  alteration  from  when 
it  was  swallowed.  It  depends  largely  on  how  long  it  has  been  in  the 
stomach  and  whether  the  stomach  has  digested  it.  When  an  animal 
vomits  when  the  stomach  is  empty,  there  generally  is  a  small  quantity 
of  water  mixed  with  the  mucus;  the  color  varies  greatly  according  to 
the  circumstances,  white,  yellowish-gray,  yellow  or  yellowish-green; 
this  latter  condition  depends  on  staining  from  bile  pigment.  Other 
colors  may  also  appear.  It  may  be  gi'cen  from  eating  grass;  violet  as 
a  result  of  licking  a  wound  or  eruption  that  has  been  treated  with  pyok- 


EXAMINATION  OF  THE  DIGESTIVE  APPARATUS  25 

tannin.  The  vomited  material  may  be  streaked  with  traces  of  blood, 
due  to  rupture  of  some  capillary  vessels  of  the  stomach.  For  further 
particulars  see  the  article  on  Ha?mostases. 

The  vomited  material  varies  according  to  the  pathological  condit- 
ions, from  a  thin  watery  fluid  to  thick  mucus.  In  acute  or  chronic 
catarrh  of  the  stomach  it  is  stringy  and  glassy.  The  presence  of  blood  in 
the  vomited  material  may  be  due  to  the  animal  swallowing  some  sharp 
foreign  body,  the  action  of  some  corrosive  poison,  from  infectious  hemor- 
rhagic gastro-enteritis,  ulceration  of  the  stomach,  gastric  ulcer,  or  we  may 
see  it  in  hemorrhage  of  the  mouth,  trachea  or  pharynx,  where  the  animal 
swallows  the  blood  and  vomiting  it  again  may  lead  to  a  mistaken  diag- 
nosis of  infectious  hemorrhagic  gastro-enteritis.  This  may  also  occur 
when  an  animal  licks  a  wound  and  thus  swallows  a  large  amount  of  blood 
and  then  vomits  it.  In  hemoptysis  (bloody  cough  from  the  respiratory 
organs)  it  is  frothy  and  a  bright  color.  In  hematemesis  (vomited  blood) , 
the  blood  is  dark,  varying  from  a  dark  red-brown  to  a  dark  brown.  In 
rare  instances  where  abscesses  form  in  the  pharynx,  oesophagus,  stomach, 
or  the  region  adjacent  to  that  organ,  when  they  break  they  may  cause 
vomiting  and  the  material  vomited  is  stained  with  blood.  Fa?cal  ma- 
terial is  sometimes  vomited  up  in  the  latter  stages  of  obstruction  of  the 
bowels  and  in  acute  diffuse  peritonitis. 

Vomited  material  is  generally  acid  in  reaction  but  it  is  alkaline  in 
poisoning  by  alkalies,  and  in  severe  hematemesis.  Vomited  material  is 
generally  pungent  and  unpleasant,  particularly  when  there  is  a  collection 
of  fatty  acids  in  the  stomach,  and  very  offensive  when  fsecal  material 
or  putrid  meat  is  vomited.  This  also  occurs  in  rare  instances,  from 
violent  poisons,  and  in  carcinoma  of  the  stomach,  etc.  A  foul  odor  may 
be  given  to  vomited  material  in  cases  of  injury  of  the  pharynx  and  oesoph- 
agus. In  cases  of  certain  poisons,  the  characteristic  odors  of  the  drug 
can  be  detected,  as  in  the  case  of  phosphorous,  carbolic  acid,  iodoform, 
or  hydrocyanic  acid.  Internal  parasites  are  frequently  found  in  vomited 
material. 

Eructation  of  gas  (belching)  is  frecjuently  seen  in  perfectly  healthy 
animals,  particularly  when  they  rise  and  stretch  themselves.  It  is  also 
seen  in  catarrh  of  the  stomach. 

Physical  Examination  of  the  Bowels  (Intestines). 

The  examination  of  the  intestines  can  either  be  made  through 
the  abdominal  wall  or  the  rectum.  The  situation  and  size  of  the  various 
abdominal  organs  can  be  seen  approximately  in  Fig.  12. 

The  manual  examination  of  the  intestines  is  made  in  the  following 
way:     The  animal  is  put  in  a  standing  position  and  placing  one  hand 


26 


DISEASES  OF  THE  DIGESTIVE  APPARATUS 


on  the  abdominal  wall  and  the  other  hand  on  the  other  side  of  the  body- 
directly  opposite,  a  steady  pressure  is  brought  to  bring  the  hands  to- 
gether and  the  ends  of  the  fingers  are  moved  from  one  position  to  another 
and  thus  outline  and  palpate  the  different  portions  of  the  intestines. 
While  doing  this,  attention  must  be  paid  to  see  if  the  animal  winces  or 
evinces  pain,  and  whether  it  is  slight  or  intense.  By  this  means  we  dis- 
cover abnormal  accumulations  of  fa?cal  matter  in  the  large  intestines, 
also  whether  there  are  any  foreign  bodies  or  tumors  in  the  intestines. 
Intense  pain  is  shown  in  the  early  stages  of  diffuse  peritonitis,  and  in  a 
milder  degree,  but  still  very  acute,  in  toxic  enteritis,  complete  obstruction 
or  stenosis  of  the  bowel,  and  in  infectious  hemorrhagic  gastro-enteritis. 


Fig.  12. — Intestinal  canal  of  the  clog.  BZ,  Caecum;  Bs,  pancreas;  G,  colon;  H,  ileum  L,  jejunum, 
M,  stomach;  md,  large  intestine;  Z,  duodenum;  1,  curve  of  the  duodenum;  1'  flexures  of  the  large  in- 
testine; 2,  convolutions  of  the  small  intestine;  3,  anus;  4,4,  anal  glands;  4',  opening  of  glands. 

If  the  bowels  are  pressed  very  hard,  pain  is  evinced  when  there  is  acute  or 
chronic  catarrh  of  the  intestines.  A  circumscribed  or  localized  pain  is 
seen  in  intestinal  stenosis,  tortion  or  volvulus  of  the  intestine  and  from 
the  presence  of  foreign  bodies.  One  must  remember  in  making  such  an 
examination  that  certain  painful  conditions  of  the  abdominal  muscles 
or  even  the  pain  that  severe  pressure  may  produce,  when  the  muscles 
are  stretched  or  compressed,  must  not  be  mistaken  for  intestinal  pain. 
In  certain  long  standing  cases  of  chronic  intestinal  catarrh,  the  writer 
has  found  a  certain  amount  of  pain  on  pressing  the  finger  tips  between  the 
loops  of  the  intestines. 

An  increase  in  the  periphery  of  the  abdomen  may  indicate  collec- 
tions of  adipose  tissue  in  the  abdomen,  pregnancy  in  bitches,  overload- 
ing of  the  stomach  with  food,  or  great  accumulation  of  faeces  in  the  large 
intestines.  The  same  condition  is  observed  from  accumulations  of  gas 
in  the  stomach  and  intestines  as  a  result  of  catarrh  of  the  stomach  and 


EXAMINATION  OF  THE  DIGESTIVE  APPARATUS  27 

intestines,  certain  poisons,  stenosis  of  the  intestines,  peritonitis,  paralysis 
of  the  intestines,  escape  of  gas  from  the  stomach  and  intestines  into  the 
abdominal  cavity  (meteorismus  peritonis),  and  also  when  these  organs 
are  punctured  by  foreign  bodies,  from  accumulations  of  fluid  in  the  ab- 
dominal cavity,  in  peritonitis  exudata,  rupture  of  the  bladder,  or  ascites. 
Particularly  relaxv>d  and  flabby  abdominal  muscles  may  often  make  an 
animal  look  as  if  it  had  dropsy  of  the  abdomen.  In  great  accumulations 
of  urine  in  the  bladder,  large  tumors  or  cysts  in  the  abdominal  cavity, 
dropsy  of  the  uterus  and  in  hydronephrosis.  Lateral  (one-sided)  disten- 
tion of  the  abdomen  may  be  caused  by  hypertrophy  of  the  liver,  disten- 
tion of  the  stomach,  various  tumors,  abscesses  of  the  abdominal  walls, 
hernise  and  other  surgical  diseases.  A  decrease  in  the  periphery  of  the 
abdomen  may  result  from  continued  diarrhoea,  lack  of  proper  or  sufficient 
food,  or  consumption. 

Large  accumulations  of  faecal  matter  in  the  colon  and  rectum  is  indi- 
cated by  a  large  sausage-like  mass  the  consistency  of  putty  and  is  pitted 
by  pressure.  These  obstructions  cause  painful  irritation  and  swelling 
of  the  mucous  membrane.  These  swellings  are  found  under  the  spinal 
column.  Foreign  bodies  that  have  been  mixed  with  the  food  or  if  an 
animal  in  play  catches  certain  objects  in  his  mouth,  such  as  glass,  stones, 
hard  or  soft  rubber  balls,  cork,  etc.,  and  accidentally  swallows  them  and 
they  become  lodged  in  the  intestines  they  are  easily  outlined  by  palpa- 
tion by  the  same  means  we  outline  tumors  on  the  abdominal  wall.  Soft 
foreign  bodies,  such  as  hair  balls,  overloading  of  the  intestines,  or  slight 
invagination  are  rather  hard  to  diagnose. 

The  rectum  is  examined  in  the  following  manner:  The  animal  is 
placed  either  in  a  standing  position  or  on  his  side,  and  the  index  fin- 
ger (or  in  small  animals,  the  little  finger),  having  been  dipped  in  oil,  is 
inserted  into  the  rectum,  the  other  hand  being  used  to  hold  the  tail  to 
one  side,  or  to  keep  the  animal  quiet.  It  is  frequently  necessary  to 
muzzle  the  animal  and  in  almost  all  cases  an  assistant  holding  the  ani- 
mal greatly  facilitates  the  examination.  Very  frequently  after  an  ex- 
amination, the  finger  is  stained  with  blood,  or  even  blood  in  large  quan- 
tities is  observed.  This  is  generally  due  to  the  venous  engorgement 
of  the  rectal  mucous  membrane  and  the  capillary  vessels  are  easily 
ruptured.  We  examine  the  rectum  when  certain  symptoms  are  shown 
in  defecation  or  the  faeces  indicate  some  abnormal  condition  of  the 
rectum,  such  as  inflammation,  abscesses,  tumors,  or  dilation  or  con- 
traction of  that  organ.  Or  we  may  examine  the  rectum  to  remove 
foreign  bodies  or  particularly  hard  pieces  of  faeces  or  to  diagnose  ab- 
normal conditions  of  the  neighboring  organs,  or  structures,  such  as  the 
prostate  gland,  vagina,  uterus,  neck  of  bladder,  or  if  tumors  or  abscesses 
are  suspected  in  the  pelvis.     In  very  small  animals  the  examination  of 


DISEASES  OF  THE  DIGESTIVE  APPARATUS 
organs    can    be    made   easier    by    palpation    of   the    abdominal 


28 

these 
wall. 

In  certain  cases  where  light  has  to  be  thrown  on  the  rectal  mucous 
membrane  the  necessary  examination  can  be  made  by  means  of  a  specu- 
lum and  then  a  mirror  or  an  electric  torch  can  be  used  to  throw  the  light 
into  the  cavity.  Inflammation  of  the  rectum  from  any  cause,  such  as 
hemorrhoids,  fistulae,  foreign  bodies,  or  abscesses,  can  be  readily  exam- 
ined by  this  means. 


lio.    i:j. — Examinatiou  of  the  lower  bowel  with  speculum. 


The   Faeces. 


The  number  of  times  that  an  animal  has  an  evacuation  of  the 
bowels  depends  on  the  two  circumstances:  The  quantity  and  character 
of  the  food  and  the  rapidity  with  which  it  passes  through  the  bowels. 
Normally,  an  animal  has  two  or  three  passages  daily;  sometimes  even 
less.  Diarrhcea,  as  a  result  of  catarrh  of  the  intestines,  may  be  due  to 
a  variety  of  causes,  such  as  irregular  diet,  cold,  or  to  some  infectious 
disease  (distemper),  latter  stages  of  infectious  hemorrhagic  gastro-enteritis, 


EXAMINATION  OF  THE  DIGESTIVE  APPARATUS  29 

septicaemia,  or  some  irritant  in  the  food;  but  it  may  also  be  caused  by 
a  laxative  independent  of  the  catarrh. 

Constipation  is  common  in  all  old  dogs  and  in  starved  animals,  in 
animals  weakened  from  exhausting  diseases,  in  animals  that  have  not 
had  sufficient  exercise,  or  fed  with  constipating  food,  icterus,  peritonitis, 
in  the  onset  of  all  diseases  with  rise  of  temperature,  in  the  majority  of 
chronic  affections  of  other  organs,  in  all  cases  of  obstruction  of  the  bowels, 
such  as  collections  of  dry  faeces  in  the  large  intestines,  atresia  ani,  from 
large  collections  of  internal  parasites,  tumors  in  the  intestines  or  adjacent 
structures,  hypertrophy  of  the  prostate  gland,  too  much  hair  around 
the  anus,  swelling  of  the  anal  glands,  or  from  tumor  of  the  anus.  Animals 
suffering  from  lumbago  frequently  do  not  attempt  to  defecate  on  ac- 
count of  the  pain  evacuation  of  the  bowels  causes  them. 

Constipation  alternated  with  diarrhoea  is  frequently  a  symptom 
of  chronic  intestinal  catarrh — due  to  twisting  of  those  organs — or  in- 
vagination, hernia,  foreign  bodies,  loss  of  the  vermicular  motion  and 
in  all  copious  exudations  from  the  peritoneum.  Pain  during  evacua- 
tion of  the  bowels  (tenesmus)  is  seen  in  inflammation  or  obstruction  of 
the  lower  bowels  and  in  inflammation  or  ulceration  of  the  rectum,  or 
rheumatism  of  the  abdominal  muscles.  Involuntary  evacuation  of  the 
bowels  is  seen  in  prolonged  attacks  of  diarrhoea,  paresis  of  the  cord, 
and  when  an  animal  is  dying,  from  the  presence  of  an  abscess,  from 
enlargement  of  the  prostate,  from  splinters  of  wood  in  the  lower  bowel, 
or  from  enlargement  of  the  rectal  glands. 

The  amount  of  excrement  passed  by  an  animal  in  a  given  time  de- 
pends on  the  quantity  and  quality  of  the  food  that  the  animal  has  taken. 
A  vegetable  diet  produces  much  more  faeces  than  a  meat  diet.  In  an 
ordinary  sized  dog  fed  on  bread,  the  amount  of  faeces  passed  amounts  to 
20  per  cent,  of  the  amount  eaten;  but  if  the  same  animal  is  put  on  a  meat 
diet  the  amount  of  faeces  is  only  about  12  per  cent.  (Ellenberger),  In 
diarrhoea  the  relative  amount  is  changed,  for  in  this  condition  the  intes- 
tinal juices  secreted  to  aid  digestion  are  not  reabsorbed,  but  remain  with 
the  faeces  and  are  thrown  out. 

After  an  obstinate  constipation  the  amount  of  fluids  is  also  greatly 
increased,  and  with  it  there  is  also  a  very  offensive  odor,  due  to  decom- 
position of  the  faeces  and  to  the  various  excrementary  matters  that  have 
remained  in  the  bowels. 

The  shape,  size  and  color  of  the  stools  are  a  rather  important  matter 
to  consider.  In  normal  health  they  are  cylindrical  in  form,  hard  or  soft, 
according  to  the  diet;  in  meat  diet  they  are  black  or  brownish- black  and 
of  pitchy  consistency.  The  faeces  of  sucking  puppies  resemble  thick 
green  pea  soup;  these  are  rarely  seen  as  the  mother  invariably  licks  them 
up.     Medicine  changes  the  color  of  the  faeces.     Calomel  and  bismuth 


30 


DISEASES  OF  THE  DIGESTIVE  APPARATUS 


stain  them  greenish-black  and  iron  preparations  turn  them  black;  on 
meat  and  fat  mixed  they  are  dark  gray-brown,  and  on  bread  and  milk 
diet  they  are  yellow-brown  or  almost  clay  color.  If  the  animal  has  eaten 
much  bones,  they  are  whitish.  The  alimentary  matter  cannot  be  dis- 
tinguished with  the  naked  eye,  except  in  the  case  of  bread,  which  is  passed 
almost  as  it  is  taken  into  the  stomach.  Bodies,  such  as  wood,  bones, 
hair,  straw,  earth,  etc.,  can  also  be  seen  in  the  faeces.  Under  the  mi- 
croscope (Fig.  14)  we  can  see  numerous  particles  of  food  that  have 
passed  without  digesting  in  animals  that  have  good  health.  In  impaired 
digestion  we  see  pieces  of  muscle,  connective  tissue,  etc.,  with  the  naked 
eye. 

The  following  deviations  in  the  appearance  of  the  faeces  may  be 
observed : 

If  the  faeces  contain  large  quantities  of  food  that  is  ordinarily  very 
easily  digested,  or  of  food  that  shows  little  or  no  evidence  of  having  been 


■iW 


Fig.   14. — Microscopical  examination  of  the  fsece?.     Vegetable  matter,  starch  cells,  muscular  fibres, 
epithelial  cells,  and  fungoid  growths. 


digested,  disorder  of  the  stomach  or  intestines  is  indicated.  This  con- 
dition may  also  result  from  fevers,  gastro-intestinal  catarrh,  from  increased 
peristalsis,  forcing  the  food  through  the  intestinal  canal  before  it  has 
had  time  to  digest,  from  fright,  the  presence  of  irritants  in  the  food, 
from  the  administration  of  laxatives  or  in  old,  exhausted  or  weakened  ani- 
mals. Biliousness  will  produce  a  stool  that  is  yellow  colored.  Continuous 
diarrhoea  produces  a  mucous  or  watery  appearance  of  the  faeces.  In 
catarrh  of  the  intestines  the  faeces  contain  a  large  quantity  of  mucus 
and  have  a  peculiarly  foamy  appearance.  Clrayish-white,  or  clayey, 
with  a  dull  gloss  indicates  a  plugging  of  the  bile  duct  or  some  stoppage 
of  the  flow  of  bile  (retentions  icterus).  The  presence  of  pus  indicates  the 
bursting  of  some  suppurative  foci  into  the  intestinal  track,  such  as  ab- 
scesses or  ulceration  of  the  large  intestine,  or  the  rectum.  Bloody  stools 
are  frequently  passed  after  a  digital  examination  of  the  rectum,  insert- 
ing the  thermometer,  from  certain  poisons,  so-called  hemorrhagic  en- 


EXAMINATION  OF  THE  DIGESTIVE  APPARATUS 


31 


teritis,  from  proctitis  (inflammation  of  the  rectum),  in  rare  instances, 
from  distemper,  infectious  hemorrhagic  gastro-enteritis,  septicaemia, 
and  in  cases  of  mycotic  meat  poisoning.  Blood  may  be  found  on  the 
surface  of  the  stool  or  mixed  with  the  pus.  Which  portion  of  the  intesti- 
nal track  the  blood  comes  from  can  be  arrived  at  in  the  following  way: 
If  the  blood  is  found  to  be  mixed  all  through  the  material  in  the  faeces  it 
comes  from  the  stomach  or  small  intestines.  But  if  the  blood  is  in  clots 
or  streaks  and  lying  on  the  surface  of  the  stool,  it  has  come  from  the 
lower  part  of  the  large  intestine  or  the  rectum.  The  color  of  the  blood  is 
diagnostic;  when  the  blood  has  escaped  into  the  intestine  in  the  anterior 
portion,  it  is  dark  brown,  a  greenish-brown,  or  even  black;  but  from  the 
lower  intestines  the  blood  is  hardly  changed  in  color  and  in  proctitis  the 


Fig.   15.— Eggs  of  intestinal  parasites  in  faeces  (round  worm).     Magnified  70  times. 

blood  is  normal  in  color,  and  is  easily  detected  in  the  faeces,  either  in  the 
form  of  pure  blood  or  bloody  mucus. 

The  odor  of  the  faeces  is  unpleasant,  nauseating  or  offensive,  especi- 
ally when  the  animal  has  had  a  meat  diet,  and  particularly  so  in  cases  of 
long-standing  constipation  from  mycotic  meat  poisoning;  or  in  the  latter 
stages  of  septicaemia,  in  distemper,  diarrhoea,  toxic  enteritis,  or  infec- 
tious hemorrhagic  gastro-enteritis.  Free  bile  in  the  faeces  gives  them  a 
particularly  offensive  odor. 

The  presence  of  the  following  objects  in  the  faeces  may  aid  in  diag- 
nosis by  giving  an  important  clue  to  certain  disorders;  stones,  sand, 
pieces  of  bone,  straw,  grass,  splinters  of  wood,  hair,  portions  of  sloughed 
tissue,  whole  or  portions  of  parasites  (ascarides,  oxyuris,  taenia)  (Fig.  15), 
and  more  minute  examination  by  means  of  the  microscope  may  determine 
the  nature  and  some  of  the  above-named  objects  if  they  should  be  in  a 
state  of  fine  division. 


32 


DISEASES  OF  THE  DIGESTIVE  APPARATUS 


Physical  Examination  of  the  Liver. 

The  liver  covers  the  posterior  surface  of  the  diaphragm  and  extends 
as  far  back  on  the  abdominal  wall  as  the  umlnlical  region.  On  the  right 
side  it  extends  posteriorly  and  laterally  along  the  ribs.  The  gall  bladder 
lies  at  about  the  height  of  the  cartilage  of  the  ninth  rib,  but  does  not 
extend  as  far  as  the  abdominal  wall. 

The  physical  examination  of  the  liver  is  very  difficult  to  make. 
Fortunately,  the  diseases  of  the  liver  in  the  dog  are  very  rare  and  can  be 
detected  by  symptoms  other  than  the  direct  examination  of  the  gland. 
The  liver  is  examined  by  percussion  and  palpation  (Fig.  16).  The  percus- 
sion area  of  the  liver  is  where  the  liver  lies  against  the  abdominal  wall  and 


Fig.   16. — Right  side  of  the  abdomen,  showing  the  position  of  the  organs. 

the  ribs;  this  takes  in  on  the  right  side  the  lower  third  of  the  eighth, 
ninth  and  tenth  ribs  and  upward  and  backward  over  the  twelfth  and 
thirteenth  ribs,  and  on  the  left  side  the  twelfth  rib.  Under  normal 
conditions  a  dull  hollow  sound  is  heard  on  the  percussion  over  the  region 
of  the  liver.  The  liver,  however,  may  vary  a  great  deal  in  the  different 
breeds  of  dogs  and  also  in  individual  animals. 

The  liver  very  frequently  is  in  an  abnormal  position  from  various 
diseases,  as  a  result  of  exudative  pleuritis,  emphysema  of  the  lungs, 
pneumothorax,  etc.,  also  when  the  stomach  and  intestines  are  filled  with 
gas  from  accumulations  of  fluid  in  the  abdominal  cavity.  Increase  in  the 
size  of  the  liver  may  indicate  hyperaemia,  fatty  liver,  amyloid  degenera- 
tion, abscesses,  carcinoma,  parenchymatous  hepatitis,  or  biliary  engorge- 
ment.    A  decrease  in  the  size  of  the  organ  is  found  in  cirrhosis  of  the  liver. 

The  palpation  of  the  liver  is  made  in  the  following  manner:  the  hand 


EXAMINATION  OF  THE  DIGESTIVE  APPARATUS  33 

is  placed  on  the  chest  wall  and  the  thumb  extends  back  of  the  curvature 
of  the  ribs  and  is  pressed  in  the  region  of  the  liver  or  the  thumb  can  be 
placed  on  the  last  rib  and  with  the  tips  of  the  fingers  the  region  of  the 
liver  palpated.  The  usual  position  of  the  animal  is  to  place  it  on  its 
side.  The  palpation  of  the  liver  is  particularly  easy  in  an  animal  having 
very  flabby  abdominal  w^alls,  or  where  a  collection  of  fluid,  such  as  ascites, 
has  just  been  removed.  Pain  on  pressure  of  the  liver  is  seen  in  cases  of 
parenchymatous  hepatitis,  in  hypersemia  of  the  liver,  and  in  early 
stages  of  cirrhosis  of  the  liver.  In  cases  of  carcinoma  of  the  liver,  large 
uneven  nodules  are  felt  on  palpation  and  in  the  latter  stages  of  cirrhosis, 
small  uneven  nodules  are  detected  on  the  surface  of  the  liver.  The  liver 
is  particularly  firm  and  inelastic  in  cirrhosis,  hyperaemia,  and  biliary 
engorgement.  Abscesses  may  be  detected  by  fluctuation,  but  only  when 
they  have  attained  a  great  size. 

The  Spleen. 

The  spleen  is  situated  in  the  left  hypochondriac  region,  is  very  diffi- 
cult to  examine  through  the  abdominal  wall.  Certain  definite  swellings 
or  engorgements  of  the  spleen  may  result  from  various  affections  of  the 
liver,  lungs,  and  heart,  from  tumors  in  the  region  of  the  porta  hepatica, 
in  various  infectious  diseases,  such  as  distemper.  When  large  splenitic 
tumors  are  present,  in  fat  animals  they  are  almost  impossible  to  detect; 
in  thin  animals  they  are  easily  detected  by  palpation.  Percussion  in 
such  cases  can  also  be  made  about  the  last  two  intercostal  spaces  at  the 
curvature  of  the  ribs. 

The  Pancreas. 

The  pancreas,  on  account  of  its  twisted  right-angle  position,  makes 
a  direct  examination  almost  impossible  (Fig.  16);  enlarged  pancreas  may 
occur  as  a  result  of  tumors,  carcinoma  or  adenoma;  they  may  be  detected 
by  palpation  in  the  region  of  the  twelfth  dorsal  to  the  third  lumbar 
vertebra.  But  it  is  generally  unsatisfactory,  and  a  diagnosis  is  better 
made  of  diseases  of  the  pancreas  by  finding  undigested  food  in  the  faeces 
and  the  presence  of  sugar  in  the  urine. 


34  DISEASES  OF  THE  DIGESTIVE  APPARATUS 


DISEASES  OF  MOUTH,  TONGUE  AND  SALIVARY  GLANDS. 
Inflammation  of  the  Mucous  Membrane  of  the  Mouth.     Stomatitis. 

Clinical  Symptoms. — The  first  symptom  the  animal  will  show  will 
be  the  slow,  careful  way  in  which  it  eats;  it  will  leave  any  large,  or  hard 
pieces  of  food  untouched,  and  swallow  small  pieces  without  mastication. 
The  saliva  is  greatly  increased  in  amount  and  frequently  runs  out 
of  the  corners  of  the  mouth  in  thin,  glass-like  threads  or  strings.  On 
making  an  examination  of  the  mouth,  all  of  the  mucous  membranes 
Avill  be  found  swollen,  red,  and  inflamed;  the  gums  are  especially  so  during 
dentition  (gingivitis) ;  the  inner  surface  of  the  cheeks,  the  tongue,  and 
soft  palate  are  also  inflamed;  as  a  rule,  the  tongue  is  coated  and  covered 
with  thick  mucus  and  saliva.  Ulcers  sometimes  appear  in  the  different 
parts  of  the  mouth  and  particularly  on  the  tip  and  edge  of  the  tongue. 

The  duration  of  the  disease  depends  largely  on  the  causes  producing 
it;  as  a  rule,  it  is  not  of  much  importance  and  disappears  without  any 
medical  interference.  In  some  cases,  where  it  is  caused  by  diseased 
teeth,  it  is  more  obstinate,  and  if  it  becomes  chronic  it  is  apt  to  become 
a  case  of  stomacace. 

Therapeutics. — The  animal  should  be  fed  lightly,  the  principal  diet 
being  soup  or  liquid  foods,  beef  extracts  or  juice  of  fresh  meats,  and  the 
animal  given  plenty  of  fresh  water  to  drink.  This  washes  out  the  thick 
saliva  and  mucus  off  the  tongue  and  between  the  teeth.  Common  salt, 
carbonate  of  soda,  or  Carlsbad  salts  or  some  such  saline  waters  as  Hunyadi, 
Apenta  or  Veronica,  can  be  used  with  good  results,  and  the  mouth  should 
be  washed  out  with  any  of  the  following  disinfectant  and  astringent  solu- 
tions: 1  to  2  per  cent,  solution  of  boric  acid,  potassium  chlorate,  5  per 
cent,  solution  of  alum,  5  per  cent,  solution  of  permanganate  of  po- 
tassium, sol.  of  peroxide  of  hydrogen  or  red  wine.  Inflamed  gums  can  be 
rubbed  with  tincture  of  myrrh,  tincture  of  catechu,  or  with  a  solution  of 
15  per  cent,  tannin  in  glycerine. 

Ulcerous  Inflammation  of  the  Mucous  Membranes  of  the  Mouth.      Ulcera- 
tive  Stomatitis    (Stomacace).     Necrotic   Stomatitis. 

Etiology. — This  is  an  inflammation  and  necrotic  ulceration  of  the 
mouth,  and  is  generally  seen  in  delicate,  weak  and  ansemic  house  dogs 
and  is  associated  with  the  presence  of  decayed  teeth  (tartar,  caries). 
It  is  seen,  however,  in  a  small  proportion  of  cases  where  the  teeth  are 
perfecti}'  sound,  and  where  the  animal  seems  to  be  in  fairly  good  health, 


STOMACACE    {necrotic  gangrene  of  the  Jaw.) 


DISEASES  OF  MOUTH,   TONGUE  AND  SALIVARY  GLANDS  35 

especially,  when  they  are  recovering  from  acute  or  exhausting  diseases. 
This  condition  in  some  cases  seems  to  be  due  to  some  bacterial  infec- 
tion of  the  mucous  membrane  and  the  tissue  directly  surrounding  the 
teeth;  the  true  nature  of  this  hypothesis  has  not  as  yet  been  settled.  It 
is  also  a  question  if  it  is  infectious,  but  if  not,  it  certainly  affects  a 
certain  number  of  animals  at  a  time.  Ulcerative  stomatitis  is  also 
seen  as  a  symptom  in  scurvy,  infectious  hemorrhagic  gastro-enteritis, 
and  in  certain  cases  of  poisoning,  particularly  mercurial.  A  simple  case 
of  stomatitis  either  from  improper  treatment  or  a  weak  nutritive  con- 
dition, may  become  an  acute  case  of  stomacace. 

Clinical  Symptoms. — At  first  the  gums  are  swollen  and  red  in  the 
neighborhood  of  certain  teeth,  generally  the  incisors  and  more  rarely  the 
molars.  The  gums  are  very  red  and  painful  to  the  touch  and  bleed  readily. 
After  a  few  days  the  inflamed  portion  becomes  green  and  dark  purple 
on  the  dividing  line  (line  of  demarcation)  with  the  other  tissues.  The 
hemorrhage  from  the  affected  parts  is  constant  and  deep  abscesses  form, 
involving  the  alveolar  processes.  This  gangrenous  inflammation  ex- 
tends and  the  teeth  become  very  loose  and  fall  out.  In  extreme  cases, 
the  jaw  becomes  affected  and  necrosis  sets  in  and  large  portions  of  the 
jaw  exfoliate.  This  condition  may  also  involve  the  neighboring  tissues; 
but  as  a  rule  the  tongue  is  rarely  affected  to  any  great  extent.  The 
odor  of  the  stomach  is  very  offensive;  there  is  a  bad-smelling,  sticky  mu- 
cus running  from  the  corners  of  the  mouth.  Generally  the  appetite  is 
fairly  good,  although  it  is  very  difficult  for  the  animal  to  masticate  or 
swallow,  and  bolting  the  food  whole,  while  affected  with  this  disease, 
has  a  tendency  to  upset  the  stomach. 

A  favorable  termination  of  this  disease  is  only  to  be  expected  in 
young,  strong,  healthy  dogs,  provided  it  has  not  become  too  far  ad- 
vanced. With  proper  treatment  and  favorable  conditions  the  ulcers 
clean  up  gradually,  and  after  two  weeks  they  are  usually  all  healed  up; 
but  sometimes  the  fever  keeps  on  increasing  and  the  disease  becomes 
septic  in  character  from  absorption  of  the  dead  tissues,  causing  blood- 
poisoning  and  collapse,  followed  by  death.  The  author  has  noticed 
a  gangrenous  lobular  pneumonia  from  the  aspiration  of  the  purulent 
matter. 

Therapeutics. — The  animal  must  be  fed  lilierally,  but  with  easily 
digested  food  and  soft  as  possible.  Remove  all  the  diseased  tissues  as 
soon  as  possible  and  prevent  the  spread  of  the  ulcerated  portions  of 
the  mucous  membrane;  wash  the  mouth  freciuently  Avith  deodorizing  or 
antiseptic  mouth  washes  such  as  have  been  mentioned  in  the  previous 
disease,  being  careful  not  to  let  the  animal  swallow  any  of  the  prepara- 
tions. This  is  done  by  holding  out  the  animal's  head  in  such  a  position 
during  the  application  of  the  medicine  that  the  fluid  will  run  out  of  the 


36  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

mouth.  The  purulent  uk-crations  are  to  be  painted  with  tincture  of  iodine 
or  touch  the  ulcers  with  any  of  the  albuminous  preparations  of  silver, 
which  are  better  than  the  stick  of  nitrate  of  silver.  As  soon  as  the 
ulcerated  surface  begins  to  granulate,  milder  astringent  mouth  washes 
may  be  used,  such  as  tincture  of  myrrh,  or  permanganate  of  potassium. 
Syringe  the  mouth  with  a  solution  of  tannin  and  glycerine,  1  to  20. 
The  general  symptoms  of  septicaemia  will  be  found  under  the  head  of 
that  disease. 

Foreign  Bodies  in  the  Tongue. 

Foreign  bodies,  such  as  pins,  needles,  fish  hooks,  etc.,  frequently  find 
their  way  into  the  tongue.  It  is  always  well  to  examine  the  mouth  care- 
fully, when  an  animal  appears  to  have  ptyalism,  where  it  is  con- 
stantly moving  the  jaw  as  if  it  were  chewing,  swallowing  or  making 
efforts  like  vomiting  or  does  actually  vomit,  or  where  the  animal  rubs  the 
mouth  with  the  paws,  as  if  to  drag  something  out  of  the  mouth.  We  may 
find  foreign  bodies,  sticks,  needles,  splinters  of  wood  in  or  under  the 
tongue.  It  is  sometimes  very  difficult  to  find  a  foreign  body,  particu- 
larly when  the  tongue  is  greatly  swollen  and  the  animal  keeps  it  con- 
stantly moving,  and  at  the  same  time  the  mouth  filled  with  thick  saliva; 
too  great  care  cannot  be  used  to  detect  a  foreign  body.  Go  all  over 
the  body  of  the  tongue  with  the  finger.  The  writer  has  found  needles, 
some  of  them  threaded,  at  the  base  and  on  the  ventral  side  of  the  tongue. 
In  some  cases  the  needles  were  completely  reversed,  the  point  being 
toward  the  tip  of  the  tongue.  To  remove  the  foreign  body,  imbedded 
in  the  tongue,  the  free  portion  of  the  tongue  should  be  pulled  out  as  far 
as  possible  by  means  of  a  pair  of  forceps.  In  some  cases  such  as  fish 
hooks,  the  foreign  body  should  be  pulled  out  in  the  direction  it  enters 
the  tongue,  so  that  the  barb  will  not  further  lacerate  the  tissues;  in  cases 
Avhere  the  fish  hook  is  ringed  in  the  shank,  it  must  be  cut  by  means  of  a 
wire  cutter.  No  treatment  is  required  after  the  foreign  body  is  success- 
fully removed. 

Gangrene  of  the  Tongue. 

This  may  occur  from  Ixnndaging  the  tongue  or  rubber  bands  put  on 
the  tongue,  maliciously  or  otherwise,  or  if  some  of  the  larger  blood 
vessels  of  the  tongue  are  cut  transversely.  The  tongue  is  greatly  swollen 
and  the  gangrenous  portion  is  separated  from  the  healthy  part  by  a 
sharply  defined  line  of  demarcation.  The  gangrenous  portion  is  dark 
bluish-red  or  bluish-black  and  covered  with  more  or  less  pieces  of  necrosed 
tissue  mixed  with  thick  mucus  and  saliva.     This  is    cold    and    non- 


DISEASES  OF  THE  TEETH 


37 


sensitive  (see  Fig.  1 7) .  In  some  cases  if  we  forcibly  pull  out  the  tongue 
the  gangrenous  portion  becomes  detached.  Experience  shows  that 
the  loss  of  a  portion  of  the  tongue  does  not  interfere  very  much  with 
the  prehension  of  the  food.  The  only  evidence  is  seen  in  the  animal 
eating  and  drinking  more  slowly.  Generally  these  cases  heal  very 
rapidly,  as  soon  as  the  gangrenous  portions  of  the  tongue  either  slough 
ofT  or  are  amputated.  It  is  remarkable  that  in  cases  where  the  tongue 
is  liluish-black  and  cold,  the  animal  will  make  a  good  recovery  with 
little  or  no  treatment  other  than  the  removal  of  the  diseased  portion. 


Fig.  i; 


— Gangrene  of  the 
tongue. 


Fig.  is. — Longitudinal  section 
through  an  incisor  tooth;  a, 
cement;  b,  enamel;  c,  ivory  or 
dentine;  d,  pulp  cavity  and  alve- 
olar dental  membrane;  e,  maxill- 
ary bone. 


For  further  treatment  see  page  34,  under  Treatment  for  Inflammation 
of  the  Mucous  Membrane  of  the  Mouth. 


DISEASES  OF  THE  TEETH. 

Dogs  are  frequently  subject  to  various  dental  disorders,  such  as  ac- 
cumulations of  tartar  on  the  teeth,  alveolar  periostitis;  rarely  caries  of  the 
teeth,  and  still  more  rarely  fistulae  of  the  gums. 

We  understand  by  tartar  of  the  teeth,  a  calcareous  deposit  on  the 
neck  of  the  teeth  at  the  border  of  the  gums.  This  is  gray,  yellowish- 
gray,  or  greenish-gray  and  sandy  or  chalk-like  in  structure.  This  tar- 
tarous  substance  is  deposited  chiefly  around  the  canine  or  molar  teeth 
and  gradually  pushes  the  gums  back  and  often  loosens  the  tooth,  which, 
acting  as  a  foreign  body,  causes  great  irritation.     Furstenberg  found 


38  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

tartar  of  the  teeth  of  a  dog  contains  calcium  carbonate  50.79  per  cent., 
calcium  phosphate  41.4.3  per  cent.,  sodium  chlorate  1.02  per  cent.,  po- 
tassium sulphate  1.02  per  cent.,  mucus  and  food  debris  4.05  per  cent., 
water  with  traces  of  magnesium  carbonate  2.71  per  cent.  The  tartar 
can  be  removed  by  scraping  it  off  with  a  small  cup-shaped  instrument 
or  a  sound  with  a  leaf-like  tongue.  Some  remove  it  with  a  hook-shaped 
pair  of  pincers.  If  there  is  a  large  quantity  of  tartar  on  the  teeth,  it  is 
best  to  put  the  dog  under  ether  and  avoid  struggling  on  the  part  of  the 
animal,  and  also  facilitate  the  removal  of  the  tartar  without  injuring 
the  soft  structures  of  the  mouth.  The  teeth  can  then  be  cleaned  with 
such  tooth  powders  as  chalk,  charcoal,  using  a  tooth  brush  or  a 
coarse  cloth,  Albrecht  advises  in  cases  of  tatar  formation  to  take  a 
blunt  stick,  cover  the  end  with  a  cloth,  and  dip  it  in  pumice  stone  and 
alcohol  and  rub  on  the  teeth. 

Alveolar  Periostitis. — Inflammation  of  the  alveolar  periosteum  or 
the  so-called  alveolar  dental  membrane  in  combination  with  suppura- 
tive periostitis  alveolaris  purulenta  (periodentitis  purulenta)  is  a  very 
important  disease,  as  it  has  a  very  important  bearing  on  the  value  of 
certain  breeds,  particularly  the  terrier  class.  If  it  affects  very  young 
animals,  it  is  apt  to  destroy  portions  of  the  enamel  and  leave  the  teeth 
unsightly  and  discolored.  This  condition  is  very  apt  to  follow  diseases 
of  the  blood  in  very  young  animals,  particularly  those  that  are  anaemic, 
have  persistent  diarrhoea  or  have  distemper  at  that  period  when  the 
permanent  teeth  are  just  about  or  are  coming  through  the  gums. 

Caries  of  the  Teeth. — This  condition  has  been  observed  by  a  num- 
ber of  authors  (Moller,  Hoffman),  but  is  of  very  rare  occurrence. 

Caries  of  the  teeth  may  result  from  the  teeth  being  broken  by 
animals  in  play  catching  hard  objects,  stones,  coal,  etc.,  sharp  bodies 
running  into  the  gums  or  becoming  imbedded  between  the  teeth. 

By  caries  clentum,  we  define  an  active  process  of  molecular  de- 
struction of  the  enamel  and  bone  of  the  teeth.  This  process  always 
begins  on  the  surface  and  mainly  in  the  cavity  of  the  crown  of  the  tooth 
forming  a  grayish  or  blackish  spot.  This  spot,  which  is  the  decayed 
part  of  the  tooth,  advances  deeper  into  the  tooth,  going  on  toward  the 
pulp.  This  penetrates  into  the  tooth  until  it  reaches  the  nerve,  and 
thus  exposes  it  to  the  atmosphere,  inflames  it  and  makes  it  very 
sensitive. 

There  are  certain  microbes  found  in  carious  teeth,  but  whether  they 
are  directly  connected  with  the  decay  of  the  teeth  is  not  definitely 
known.  True  dental  caries  is  very  rare  in  the  dog.  Necrosis  of  the 
teeth  is  frequently  mistaken  for  caries.  In  old  dogs  we  often  see  an 
acute  inflammation  of  the  periosteum  and  the  alveolar  process  becoming 
inflamed,  the  tooth  is  lifted  out  of  its  socket,  and  finally  forced  out  entirely. 


DISEASES  OF  THE  TEETH  39 

In  these  cases  the  alveolar  periosteum  is  destroyed,  and  a  necrotic  condi- 
tion of  the  tooth  causes  it  to  become  yellow;  this  is  generally  termed  false 
caries  of  the  teeth.  Alveolar  periostitis  commences  with  the  formation 
of  an  abscess  at  the  root  of  the  tooth,  and  the  pus  formed  finds  its  way  to 
the  outside  of  the  gums  through  the  alveolar  process.  It  forms  a  fluc- 
tuating swelling  on  the  gums  (abscess  of  the  gums) ;  the  opening  gener- 
ally remains  so,  and  if  it  is  in  the  superior  maxillary  open  fistulous 
tracts  may  form  under  the  eye  just  below  the  lower  eyelid,  and  unless 
carefully  examined  may  be  mistaken  for  a  lachrymal  fistula.  By  means 
of  a  flexible  probe  the  diagnosis  can  be  made  with  certainty. 

In  all  these  cases  the  animals  seem  to  have  a  more  or  less  severe 
toothache;  they  are  irritable,  eat  very  slowly  and  irregularly,  drop  more 
or  less  saliva,  refuse  to  have  the  mouth  examined,  and,  if  the  affected 
tooth  is  struck  with  something  (a  key  is  the  best) ,  howl  and  evince  great 
pain,  keeping  the  mouth  open  for  some  time  afterward.     When  the  mouth 


Fig.   19. — Improvised  gag  (French). 

is  examined,  the  gums  are  swollen  and  painful,  and  there  is  a  very  foetid 
unpleasant  odor  from  the  mouth. 

When  there  is  more  or  less  pus  present,  the  radical  treatment  is 
to  remove  the  offending  tooth.  For  this  purpose  open  the  mouth  by 
means  of  the  method  described  on  page  12,  using  the  mouth  speculum 
(Figs.  4,  5  and  6),  or  Fig.  19,  which  show's  a  mouth  ga^"  that  is  partic- 
ularly useful  where  the  incisor  or  canine  teeth  are  to  be  examined  as  it 
can  be  easily  improvised  and  allows  the  mouth  to  be  examined  and  at 
the  same  time  the  animal  does  not  open  the  mouth  and  move  around  the 
tongue  and  interfere  with  the  examination  and  an  assistant  can  hold  the 
head  steady  and  with  an  ordinary  molar-forceps  extract  the  tooth,  being 
careful  to  avoid  breaking  the  crown.  The  tooth  is  seized  with  the  for- 
ceps as  far  down  on  the  root  as  possible;  it  is  first  loosened  by  twisting 
it  several  times  from  side  to  side  and  then  drawn  out  with  a  strong  pull. 
The  mouth  must  be  thoroughly  cleansed  with  warm  water  and  the  gums 
pressed  firmly  together,  so  as  to  keep  the  cavity,  if  possible,  from  filling 
up  with  a  blood  clot.  This  should  be  done  immediately  after  extraction. 
In  cases  of  caries  of  the  teeth,  the  tooth  can  be  filled  by  first  scraping 


40 


DISEASES  OF  THE  DIGESTIVE  APPARATUS 


out  the  cavity  with  the  dental  cutter  then  disinfect  the  cavity  by  means 
of  a  plug  of  cotton  soaked  in  creosote,  and  washed  out  with  alcohol  or 
ether  and  plugging  it  with  amalgam,  cement  or  gutta-percha.  Hobday 
has  described  a  case  where  an  artificial  tooth  has  been  bridged  between 
two  teeth.  In  the  United  States  this  bridge-work  and  filling  is  done 
frequently. 

Dentition. — Newly  born  puppies  do  not  have  any  teeth  through  the 
gums.  The  first  or  temporary  incisors  appear  a])out  the  third  or  fourth 
week  and  the  first  permanent  teeth  appear  about  the  fifth  month.  The 
temporary  canines  appear  about  the  fourth  or  fifth  week  after  the  tempo- 
rary incisors  are  all  in.  The  permanent  teeth  begin  to  come  through 
about  the  third  or  fourth  month;  the  lateral  and  middle  incisors 
appear  about  the  end  of  five  months,  and  at  the  same  time  the  second, 


Fig.  20. — Tumors  of  the  gums. 

third,  and  fouth  molars,  the  fifth  molar  about  five  months,  the  sixth 
about  six  months,  and  finally  the  seventh  about  the  end  of  the  seventh 
month,  so  that  the  dog  has  his  full  masticatory  apparatus  at  the  end  of 
seven  months. 

Change  from  the  normal  rotation  of  temporary  to  permanent  teeth 
varies;  sometimes  the  permanent  teeth  will  come  through  the  gums  and 
push  the  temporary  teeth  to  one  side,  but  the  latter  remain  in  the  jaw. 
This  is  particularly  noticeable  in  the  very  small  breeds.  This  is  gen- 
erally avoided  by  pulling  out  the  temporary  incisors  as  soon  as  possible. 
Very  frec;[uently  this  allows  the  permanent  teeth  to  come  through  the 
gums  at  once  and  assume  their  normal  position.  This  irregularity  is 
particularly  noticeable  when  the  animals  are  affected  with  some  acute 
infectious  disease,  such  as  distemper. 

During  the  process  of  teething,  the  gums  become  very  red  and  in- 
flamed, and  there  is  an  increased  amount  of  saliva;  in  some  cases  the  in- 
flammation is  intense,  with  complete  loss  of  appetite.     Convulsions  may 


DISEASES  OF  THE  TEETH  41 

occur  from  reflex  nervous  irritation.  This  nervous  irritation  may  pro- 
duce a  cramp  of  the  lower  jaw  that  is  very  similar  to  the  paralysis  of  the 
jaw  in  rabies. 

These  cases  are  best  treated  by  simple  sedatives,  and  if  the  gums 
seem  to  be  tough,  they  should  be  lanced  with  an  ordinary  gum  lancet, 
and  thus  assist  the  tooth  to  come  through  to  the  surface. 

Malformations  of  the  Cavity  of  the  Mouth. — Malformations  or  growths 
on  the  buccal  membrane  are  frequently  seen  in  the  dog,  located  about  the 


Fig.  21. — Wire  ecraseur. 

edge  of  the  gums  and  on  the  inner  cheek.  They  are  generally  classed  as 
epulides.  They  vary  in  size  from  a  pin-head  to  a  walnut.  They  are 
invariably  pedunculated;  very  rarely  they  are  seen  with  an  extended  base, 
irregular  on  the  surface;  they  are,  as  a  rule,  hard  and  elastic  and  deep 
red  in  color;  they  may  occur  in  various  characters — fibroma,  carcinoma 
or  sarcoma.  The  author  observed  a  melanotic  sarcoma  in  one  case. 
These  epulides  grow  sometimes  to  be  very  large,  pushing  the  teeth  to  one 
side,  making  mastication  very  difl&cult,  and  preventing  closure  of  the 
mouth  (see  Fig.  20) . 


Fig.  22. — Warts  of  the  mouth. 

These  tumors  can  be  removed  by  ecraseur  of  wire  (Fig.  21)  or  by 
cutting  them  out  with  a  probe-pointed  bistoury.  The  hemorrhage  can 
be  checked  by  the  thermo-cautery  or  by  a  solution  of  chloride  of  iron,  but 
the  hemorrhage  is  generally  so  slight  as  not  to  require  any  styptic. 
Loose  teeth,  or  teeth  that  are  firm  but  interfere  with  the  removal  and 
eradication  of  the  tumor  should  be  extracted.  If  the  tumor  is  firmly 
attached  to  the  bone  or  directly  in  the  bone  substance  itself,  the  affected 
bone  should  be  removed  with  the  knife  or  bone  forceps  and  scraped  with 


42  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

a  curette  so  as  to  prevent,  if  possible,  the  recurrence  of  the  growth; 
but  frequently  they  return  in  spite  of  every  precaution. 

Warts  in  the  Mouth. — In  young  dogs,  generally  under  twelve 
months,  we  frequently  find  on  the  lips,  buccal  membrane,  and  under 
the  tongue  numbers  of  papilloma;  these  sometimes  occur  in  enormous 
numbers.  These  are  small  whitish-gray,  pink  or  pinkish-black,  wart- 
like proliferations  (see  Fig.  22).  These  growths  are  generally  of  little 
importance.  They  may  appear  in  a  few  days  and  cover  the  surface  of  the 
mouth  and  disappear  as  rapidly  as  they  appear.  No.  treatment  is  re- 
garded unless  they  are  in  such  masses  as  to  interfere  with  mastication. 
If  so,  remove  the  largest  with  a  curved  pair  of  scissors  and  dress  the 
mouth  with  some  astringent  wash,  and  administer,  liq.  potassii  arse- 
natis  (Fowler's  solution)  internally  in  the  food. 

Ranula. — Besides  these  tumors  of  the  membranes  of  the  mouth  we 
find  a  growth  called  ranula.  It  generally  occurs  under  or  on  the  side 
of  the  ventral  surface  of  the  tongue  and  rarely  painful  to  the  touch,  thin 
walled,  and  more  or  less  cylindrical.  Often  an  animal  will  become  very 
slow  in  eating,  and  if  the  mouth  is  examined,  we  find  on  one  side  of  the 
tongue  and  under  it  a  large-sized  body,  varying  from  the  size  of  the  little 
finger  to  a  chicken's  egg,  a  fluctuating  swelling,  reddish-blue  in  color 
and  when  opened  with  a  knife  it  is  found  to  be  filled  with  a  thick  creamy 
glue-like  liquid  (see  Plate,  page  42) .  Many  theories  have  been  advanced 
as  to  the  cause  of  this  disease;  some  consider  it  to  be  the  formation  of  an 
ordinary  cyst  and  others  contend  it  is  due  to  the  plugging  of  the  ducts 
of  one  or  more  of  the  salivary  glands  at  the  base  of  the  tongue.  In  some 
cases  the  cause  of  the  trouble  is  due  to  the  obstruction  of  the  duct  of 
Wharton,  which  has  its  entrance  into  the  mouth  at  the  base  of  the  lin- 
gual ligament,  and  in  other  cases  it  is  a  cystoid  degeneration  of  a  few 
glands  at  the  base  of  the  tongue,  probably  due  to  a  plugging  of  the  open- 
ing of  their  ducts  and  a  consequent  inflammation  of  the  glands  themselves. 
It  therefore  seems  best  to  call  all  the  cystoid  formations  under  the  tongue 
ranula. 

It  is  always  advisable  to  operate  on  these  cysts;  cut  down  on  the 
cysts  with  a  lancet  and  make  a  good-sized  opening,  and  by  mean-s  of  a  pair 
of  curved  scissors  remove  a  portion  of  the  upper  part  of  the  wall  and 
cauterize  the  inner  w\alls  of  the  cysts  with  the  thermo-cautery  or  stick  of 
caustic  silver.  If  Wharton's  duct  is  involved,  be  guarded  in  the  cauteriza- 
tion, confining  it  only  to  the  anterior  part  of  the  cyst  toward  the  point 
of  the  tongue.  The  injection  of  pilocarpine,  which  has  been  used  with 
success  in  man  according  to  Soffintini's  method,  has  been  tried  in  ani- 
mals by  Hoffmann.  It  consists  in  creating  a  great  amount  of  the  salivary 
secretion,  and  the  force  of  the  collected  fluid  from  the  inside  breaks  the 
obstruction  of  the  duct. 


RANULA    (salivary  cyst  of  the  tongue.^ 


DISEASES  OF  THE  TEETH 


43 


Inflammation  of  the  Salivary  Glands. 

{Parotitis;  Mumps.) 

Inflammation  of  the  glands  of  the  ear  (parotiditis)  appears  either 
as  a  consequence  of  some  mechanical  cause,  or  by  infection  from  the  cav- 
ity of  the  mouth,  from  some  existing  inflammation  of  that  part,  as  a 
disease,  due  to  the  presence  of  a  micrococcus  which  develops  in  the  saliva 
in  the  form  of  a  diplostreptococcus  or  by  direct  infection  from  the  blood 
itself  in  the  form  of  a  diplococcus  or  from  metastasis  (septicaemia,  pyaemia, 
or^  in  rare  instances,  distemper) .     The  latter  requires  special  mention  as 


Fig.  23. — Glands  of  the  head:  1,  parotid  gland;  2,  submaxillary  gland;  3,  subzygomatic  gland;  4, 
Wharton's  duct;  5,  Bartholin's  duct;  6,  palatine  gland;  7,  orbital  gland;  8,  Nuckian  duct;  9,  lachrymal 
gland. 

a  primary  idiopathic  parotitis  (mumps).  The  writer  has  frequently 
seen  the  gland  in  the  region  of  the  ear  affected,  more  rarely  the  glands 
of  the  lower  jaw,  and,  least  of  all,  the  glands  of  the  eye. 

Etiology. — This  disease  is  rather  rare  in  the  dog,  but  sometimes  it 
may  take  the  form  of  an  epizootic  (Hertwig,  Schussele).  In  these  cases  it 
is  probably  due  to  some  infecting  virus  that  gets  into  the  gland  through 
Steno's  duct.  The  exact  nature  and  time  of  incubation  of  this  disease 
are  not  known. 


44  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

Symptoms. — The  disease  begins  with  a  swelling  of  the  gland  and 
the  adjacent  structures  on  one  side  or  both  sides  of  the  ear.  The  loca- 
tion of  these  glands  is  seen  in  Fig.  23.  They  swell  rapidly  and  are  very 
tender  to  the  touch,  changing  the  whole  appearance  of  the  head  and 
neck.  The  animal  is  very  droopy,  carries  the  head  and  neck  in  a  fixed 
position,  eats  with  great  difficulty,  and  will  swallow  only  very  small 
pieces.  The  saliva  is  very  thick  and  forms  tenacious  bubbles  at  the 
corners  of  the  movith.  The  fever  is  seldom  high,  and  in  the  majority  of 
cases  in  from  five  to  eight  days  the  swelling  decreases  and  disappears 
entirely  in  fourteen  days  (Hertwig). 

In  rare  cases  an  abscess  is  formed  in  the  gland,  (abscess  of  the  parotid,) 
and  invariably  in  one  only.  The  gland  swells  as  in  mumps,  only  is  much 
quicker  and  surrounding  tissues  are  much  swollen  and  oedematous, 
8oon  a  fluctuating  portion  is  felt,  which  later  opens  in  one  or  more 
places  and  a  thick,  creamy  pus  escapes;  the  oedema  of  the  surrounding 
tissues  disappears  quickly,  and  the  fever,  which  is  rarely  of  much  conse- 
quence, goes  down  entirely  and  the  wound  closes  in  a  short  time. 

The  inflammation  of  the  glands  of  the  tongue  and  lower  jaw  gen- 
erally forms  abscesses  which  open  in  the  month,  the  pus  escapes,  and  the 
sore  heals  up  in  a  short  time.  The  submaxillary  generally  breaks 
through  the  skin  and  the  sul^lingual  into  the  cavity  of  the  mouth.  There 
is  never  any  consequence  in  any  of  these  cases. 

Therapeutics. — In  the  primary  form  of  parotitis,  where  we  do 
not  have  the  formation  of  an  abscess,  we  obtain  good  results  with  warm 
applications.  Keep  the  animals  as  quiet  as  possible,  and  then  rub  on 
ointments,  such  as  vaseline  and  lanoline,  or  paint  with  tincture  of  iodine. 

As  soon  as  we  see  that  the  swelling  is  not  going  down  within  a  cer- 
tain time,  but  increasing  gradually,  we  must  try  and  open  the  abscess 
as  soon  as  possible  and  allow  the  pus  to  escape.  If  fluctuation  can  be  felt, 
cut  down  on  that  point,  but  if  not,  a  portion  of  the  skin  and  fascia  have 
to  be  carefully  cut  in  the  dependent  portion,  making  a  good-sized 
opening.  The  gland  is  now  exposed,  the  pus  can  be  detected  and  opened, 
a  drainage-tube  inserted  and  sewed  to  the  tissues — if  not  sewed,  the 
animal  will  shake  it  out — and  cleanse  daily  with  an  antiseptic  solution. 
It  is  better  not  to  bandage  the  neck,  as  it  interferes  with  the  tube;  in 
some  cases  it  is  not  necessary  to  insert  the  tube,  but  to  clear  the 
opening  daily  and  dilate  it,  if  necessary.  These  abscesses  heal  rapidly  if 
there  is  exit  for  the  pus. 

Inflammations  of  the  other  salivary  glands  should  be  treated  in 
the  same  way.  The  abscess  of  the  sul)maxillary  should  be  opened  from 
the  outside  through  the  skin,  and  sublingual  from  the  inside  of  the  mouth 
cavity.  In  the  submaxillary,  it  is  not  necessary  to  put  in  a  drainage- 
tube,  but  simply  to  keep  the  wound  clean.     Frequently  we  have  develop- 


DISEASES  OF  THE  TEETH  45 

ing  in  this  region  intense  localized  inflammations  and  great  oedema  from 
traumatisms,  such  as  fights,  blows  or  contusions.  The  swelling  may 
extend  to  the  head  and  neck  (Fig.  24).  The  treatment  in  such  cases 
consists  in  making  a  free  opening  to  allow  the  pus  to  escape  and  heal  it 


Fig.  24. — Abscess  of  the  neck.     CEdema  of  the  right  side  of  the  head. 

as  an  open  wound  or  dress  it  with  an  antiseptic  held  in  place  by  means 
of  a  Priessnitz  compress. 

Occasionally  we  find  cysts  form  in  the  glands  of  the  tongue.  These 
were  first  described  by  Siedamgrotsky  as  honey  cysts.  They  are  seen 
on  the  lower  side  of  the  mouth  in  the  region  of  the  larynx,  and  are  covered  by 
the  muscles  of  the  neck;  or  they  may  be  on  both  sides  of  the  larynx  and 


Fig.  25. — Mucous  cyst. 

appear  as  a  conglomeration  of  small,  crowded  vesicles  with  thin,  coarse 
walls  filled  with  a  thick,  honey-like  fluid  (see  Fig.  25).  In  some  instances 
it  is  very  thick,  like  cheese,  and  yellow  or  reddish.  They  originate  in 
the  glands  of  the  tongue,  and  as  the  cyst  walls  extend  into  the  tissue  of 
that  organ  they  must  be  classed  under  the  head  of  ranula. 


40  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

In  treating  these  cysts  the  only  practical  method  to  pursue  is  to 
remove  them  entirely,  for  if  they  are  simply  cut  into  they  return  in  a 
short  time;  but  to  cut  out  entirely  a  cyst  located  in  this  region  is  a  rather 
dangerous  operation,  as  the  base  of  the  tongue  and  the  region  of  the 
larynx  contain  a  large  number  of  important  blood  vessels  and  nerves 
and  even  if  the  entire  cyst  is  removed,  we  may  injure  the  submaxillary 
gland,  causing  a  salivary  fistula  that  is  impossible  to  heal.  Consequently 
it  is  only  advisable  to  attempt  to  remove  the  smaller  cysts;  the  larger  ones 
can  be  treated  in  the  following  manner:  Make  an  incision  into  the  cyst, 
then  inject  into  it  some  mild  corrosive  such  as  diluted  tincture  of  iodine, 
a  weak  solution  of  corrosive  sublimate,  or  Lugol's  solution  of  iodine.  These 
sohitions  act  as  irritants  to  the  walls  of  the  cysts,  break  them  down,  and 
destroy  the  secreting  membrane  and  they  soon  heal  up;  the  cicatricial  con- 
traction draws  the  tissues  together  and  only  a  trace  is  left.  Another  method 
is  to  use  an  aspirator  or  ordinary  syringe,  draw  off  the  contents  of  the  cyst, 
and  inject  into  the  cyst  a  3  to  5  percent,  dilution  of  Lugol's  solution,  in- 
jecting an  amount  equal  to  the  original  contents  of  the  cyst.  The  object 
of  this  injection  is  to  stimulate  the  formation  of  pus  in  the  sac.  If  it  does 
not  produce  the  desired  effect,  inject  it  again.  After  the  pus  has  formed, 
make  a  long  incision  through  the  cysts  and  treat  it  as  a  simple  surgical 
wound.  Frick  advises  after  opening  the  cyst  to  cauterize  it  with  the  thermo- 
cautery and  sew  up  the  opening.  This  causes  that  portion  to  slough  off, 
and  the  wound  to  heal  by  granulation.  The  method  suggested  by  Siedam- 
grotsky  has  been  very  satisfactory  to  the  author.  It  consists  of  making 
a  good,  big  opening  in  a  dependent  part  and  injecting  the  parts  freely 
with  mild  caustic  solutions,  such  as  caustic  potash  or  tincture  of  iodine. 

Inflammation  of  the  Mucous  Membrane  of  the  Throat. 

{Pharyngitis;  Angina  Catarrhalis;  Sore   Throat.) 

This  disease  in  the  dog  is  not  by  any  means  as  important  as  it  is  in 
man,  and  as  yet  there  have  not  been  recognized  any  cases  in  the  dog  that 
could  be  compared  with  diphtheria,  angina  tonsillaris,  and  retropharyn- 
geal abscess  of  man;  at  least  such  is  the  experience  of  the  writers.  The 
general  affections  observed  have  been  common  catarrhal  inflammations 
which  involve  the  whole  or  part  of  the  throat. 

Etiology. — The  same  causes  that  would  produce  stomatitis  would 
bring  on  inflammation  of  the  throat.  The  most  common  cause  of  angina 
catarrh  is  a  continuation  of  the  inflammatory  processes  from  the  neigh- 
boring organs;  for  instance,  in  catarrh  of  the  nose,  or  in  laryngitis,  and  it 
may  appear  as  a  complication  of  distemper  and  stomatitis.  The  chief 
cause  is  cold,  particularly  in  hunting  dogs,  such  as  setters  or  pointei-s 
getting  wet,  when  very  warm,  plunging  into  very  cold  water,  or  in  house 
pets  that  run  from  very  warm  rooms  into  the  cold  and  lie  on  cold  bricks 


DISEASES  OF  THE  TEETH  47 

or  flag  stones.  This  disease  is  very  much  more  common  in  winter  than 
summer  and  is  more  frequently  seen  in  small  or  particularly  fine  bred 
delicate  animals.  Friedberger  and  Frohner  describe  an  epidemical 
infectious  pharyngitis  that  affects  young  animals  when  they  are  from 
one  to  two  wrecks  old,  and  sometimes  goes  through  an  entire  kennel, 
attacking  all  ages. 

Pathological  Anatomy,  Clinical  Symptoms  and  Cause. — The  changes 
of  the  mucous  membranes  of  the  pharynx  and  soft  palate  are  the  same 
as  are  recognized  in  all  catarrhal  inflammations.  The  mucous  mem- 
brane is  a  diffused  red,  sometimes  spotted,  and  coated  with  a  dirty 
yellow  mucus,  giving  it  a  dull  glairy  appearance.  The  membrane  puru- 
lent on  its  surface,  except  in  very  grave  affections,  when  especially  on 
its  tlorsal  surface  there  may  be  seen  a  number  of  small,  irregular  gran- 
ulations. As  a  rule,  if  the  inflammation  is  at  all  severe,  the  tonsils 
are  also  swollen  and  protrude  out  of  their  membranous  pouches  in  the 
shape  of  brownish-red  enlargements,  and  occasionally  the  subparotid 
glands  may  be  involved  by  the  formation  of  an  abscess.  We  very  rarely 
see  any  fibrinous  (croupal)  membranes  in  any  of  the  severe  inflamma- 
tions of  the  throat. 

Clinical  Symptoms. — The  clinical  symptoms  of  catarrh  of  the  throat 
are  similar  to  acute  stomatitis,  and  it  is  only  by  making  a  careful  exami- 
nation of  the  throat  that  we  can  make  a  correct  diagnosis.  In  more 
severe  cases,  beside  increase  and  alteration  in  the  saliva,  which  is  thick 
and  tenacious,  on  manipulation  in  the  region  of  the  pharynx,  it  is  pain- 
ful. The  subparotid  lymph  glands  also  are  swollen  and  painful,  and 
there  is  a  certain  stiffness  of  the  neck.  The  mucous  membrane  of  the 
pharynx  should  be  examined  and  its  changes  from  the  normal  considered. 
The  author  has  found,  as  a  rule,  that  catarrh  of  the  stomach  accompanies 
all  these  cases.  Catarrh  of  the  nasal  passages  and  pharynx,  and  slight 
fever  is  also  seen  in  these  cases,  and  in  rare  instances  vomiting.  The 
course  of  the  disease,  as  a  rule,  is  favorable,  but  Frohner  says  if  the  in- 
flammation of  the  pharynx  extends  into  the  Eustachian  tube  it  may  cause 
deafness.  Chronic  pharyngeal  catarrh  is  rarely  or  ever  seen,  but  some- 
times an  ordinary  case  of  catarrh  of  the  pharynx  may  last  three  or  four 
weeks  and  cases  have  been  known  to  recur  from  time  to  time* 

Therapeutics. — First  examine  the  larynx  and  see  if  there  are  any 
foreign  bodies  present.  This  can  be  done  by  forcing  open  the  mouth  and 
by  means  of  a  spoon  handle  or  a  spatula  the  tongue  is  depressed  and  the 
fauces  examined.  Always  be  sure,  however,  to  determine  that  the  animal 
is  not  suffering  from  dumb  rabies.  In  these  cases  the  owners  are  very  apt 
to  imagine  the  animal  has  something  stuck  in  the  throat  or  eaten  some- 
thing that  is  poisonous.  In  a  mild  case  give  the  animal  milk,  thin  soup 
bouillon;  in  more  severe  cases,  an  external  liniment,  such  as  camphorated 


48  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

oil  or  soap-linimcnt,  .should  be  rubbed  on  the  throat  or  the  mouth  held 
open  and  by  means  of  a  brush  or  an  atomizer  sprayed  directly  on  the 
throat;  apply  such  astringent  and  antiseptic  throat  washes  as  lime  water, 
tannic  acid  1  to  3  per  cent.,  potassium  chlorate  of  borax  2  to  3  per  cent, 
solution.  In  more  acute  or  chronic  cases,  wash  the  mouth  out  with  a 
solution  of  permanganate  of  potassium,  boric  or  salicylic  acid,  or  paint 
the  throat  with  nitrate  of  silver,  1  to  2  per  cent.,  or  tannite  of  glycerine, 
5  to  10  per  cent. 

DISEASES  OF  THE  (ESOPHAGUS. 
Foreign  Bodies  in  the  (Esophagus. 

The  foreign  bodies  that  become  fixed  in  the  pharynx  or  oesophagus 
of  the  dog  in  play  or  by  gulping  down  their  food  as  fast  as  possible,  if  an- 
other animal  is  near,  are  numerous  and  varied;  they  consist  of  portions  of 
food,  such  as  hard,  irregular-sized  pieces  of  meat  that  have  been  taken  in 
one  gulp;  long,  sharp  pieces  of  bone,  such  as  mutton  or  fish,  pieces  of  wood, 
needles,  or  small  stones;  sometimes  objects  are  swallowed  by  accident, 
such  as  stones,  buttons,  glass,  or  india-rubber  balls,  corks,  etc.,  and  lodged 
in  the  pharynx  at  the  entrance  of  the  oesophagus;  or  if  the  object  is  small, 
it  may  go  a  certain  distance  into  the  tube  and  lodge  there. 

The  symptoms  may  come  on  very  suddenly  and  vary  according  to  the 
general  character  and  position  of  the  foreign  body.  As  a  rule,  the  animal 
is  restless  and  keeps  the  head  and  neck  extended;  it  scratches  itself  on  the 
throat  with  the  paws  over  the  spot  where  the  obstruction  is  located.  If  it 
is  in  the  pharnyx,  the  animal  shows  signs  of  choking  or  may  vomit,  from 
time  to  time,  small  quantities  of  mucus  and  saliva,  which  is  dirty  and 
frothy  and  may  be  stained  with  blood,  and  later  pieces  of  undigested  food 
which  in  the  later  stages  becomes  foetid.  It  coughs  frequently,  and  if  the 
obstruction  is  large,  it  refuses  to  eat  or  drink.  If  water  is  forced  on  the 
animal,  it  passes  down  the  throat  very  slowly  and  evidently  with  diffi- 
culty, or  may  be  vomited  immediately  after  it  is  swallowed.  If  the 
foreign  body  is  in  the  oesophagus,  it  may  be  felt  externally  with  the  finger 
or,  opening  the  mouth  and  depressing  the  tongue,  it  may  be  seen  lodged  in 
the  pharnyx;  if  it  is  in  the  cervical  portion  of  the  oesoiDhagus,  it  can  be  de- 
tected by  making  a  careful  examination  along  the  course  of  the  tube  or  by 
the  probang  introduced  into  it,  as  has  been  described  on  page  17.  The 
latter  method  is  the  only  way  to  positively  determine  the  presence  of  a 
foreign  body  when  it  has  lodged  in  the  thoracic  portion  of  the  oesophagus. 
In  introducing  the  probang  it  must  be  carefully  inserted,  and  if  it  should 
come  in  contact  with  the  foreign  body  too  great  pressure  must  not  be  made 
on  it,  as  it  is  apt  to  pack  the  object  more  firmly  or  even  cause  perforation 


FOREIGN  BODIES  IN  THE  (ESOPHAGUS  49 

of  the  tube,  "When  making  an  examination  of  the  tube  externally,  should 
we  find  a  part  that  is  painful,  we  must  not  consider  it  the  obstruction  un- 
less we  find  a  hard  swelling  with  it,  as  foreign  bodies  such  as  sharp  splin- 
ters of  bone  or  wood  often  go  down  the  tube,  lacerate  the  mucous  mem- 
brane in  its  passage,  and  do  not  become  imbedded.  Needles,  pins  and 
small  pieces  of  wood  may  not  be  detected,  even  with  the  probang;  in  such 
cases  the  Rontgcn  or  X-ray  can  be  used  to  detect  objects  of  certain  den- 
sity, such  as  metals,  coins,  etc.,  with  the  greatest  certainty. 

The  object,  if  it  goes  into  the  stomach,  passes  through  the  intestines 
and  is  passed  through  the  rectum  and  causes  no  further  trouble.  Some 
authors  have  observed  needles  passed  per  rectum  in  the  faeces.  It  may, 
however,  lodge  in  the  stomach  and  cause  irritation  and  finally  convul- 
sions and  death.  If  it  is  a  sharp  body,  it  may  perforate  the  stomach,  even 
find  its  way  out  again  by  perforating  the  abdominal  wall.  If  it  is  in  the 
thoracic  portion  of  the  tube,  it  may  penetrate  the  wall,  cause  an  abscess 
and  escape,  or  it  may  penetrate  the  wall  of  the  thoracic  portion  and  set  up 
septic  pleuritis  and  result  fatally.  It  is  also  probable  that  death  may 
occur  from  the  foreign  bodies  if  they  are  sharp,  by  penetrating  either  the 
heart  or  one  of  the  large  blood  vessels  in  the  vicinity,  and  causing  a  hemor- 
rhage, or  it  may  also  occur  from  septic  inflammation  of  the  oesophagus. 

Therapeutics. — The  treatment  differs  according  to  the  character  and 
situation  of  the  foreign  bodies.  If  the  foreign  body  is  in  the  pharynx  or  at 
the  entrance  of  the  oesophagus,  it  must  be  removed  immediately  either 
with  the  finger  or  a  pair  of  curved  forceps.  If  the  obstruction  is  located 
in  the  lower  portion  of  the  tube,  and  it  cannot  be  pushed  down  into  the 
stomach  with  the  probang,  it  is  advisable  to  attempt  to  get  it  up  by  an 
emetic — a  subcutaneous  injection  of  apomorphia  muriate,  as  per  page  21. 
If  that  is  not  successful,  then  perform  oesophagotomy  as  soon  as  possible, 
before  the  intense  swelling  interferes  with  the  operation.  If  this  opera- 
tion cannot  be  performed  on  account  of  the  foreign  body  being  situated 
too  deeply  in  the  thorax,  it  is  best  to  give  the  animal  small  quantities  of 
lubricating  substances,  such  as  olive  oil  or  any  fatty  oil.  It  is  better  to  do 
this  than  to  use  any  great  force  to  push  the  object  into  the  stomach.  If 
the  foreign  body  goes  so  far  into  the  oesophagus  that  it  lodges  in  the  cardiac 
portion  of  the  stomach  and  by  manipulation  it  can  be  detected,  gastrec- 
tomy can  be  performed  and  the  foreign  body  removed  in  that  way. 
Porcher  and  Morey  performed  this  operation  successfully. 

In  very  rare  instances  we  also  find  an  inflammation  of  the  oesophagus 
(oesophagitis) ,  with  or  without  any  ulceration.  In  the  latter  case  it  is  due 
to  the  irritation  of  caustic  poisons  or  lacerations  of  the  foreign  bodies 
going  down  the  tube.  This  is  best  treated  with  lubricating  oils,  such  as 
almond  or  sweet  oil.  We  may  see,  occasionally,  a  constriction  of  the 
oesophagus  (stenosis  oesophagi)  or  a  dilation  (ecktasia  and  diverticulum), 
4 


50  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

but  these  conditions  are  impossible  to  improve  by  any  surgical  means  that 
we  know  of  at  present. 

OEsophagotomy. — This  is  not  a  very  difficult  operation  to  perform  in  a 
dog.  The  animal  is  laid  on  his  right  side,  and  if  not  too  weak,  is  narco- 
tized or  the  locality  sprayed  with  chloride  of  ethyl.  The  oesophagus  is 
now  exposed  and  examined  to  see  if  any  portion  is  gangrenous  from  the  in- 
j  ury .  After  having  shaved  off  the  hair,  and  washed  the  surrounding  tissues 
with  antiseptics,  the  foreign  body  is  located,  and  an  incision  is  made  in  the 
skin  parallel  with  the  jugular  vein  and  over  the  foreign  body.  The  incision 
is  now  carried  through  the  subcutaneous  tissues  and  muscles,  and  the 
oesophagus  is  exposed.  Where  the  foreign  body  is  located  in  the  lower  por- 
tion of  the  cervical  region,  the  incisions  can  be  made  on  the  median  line 
and  by  separating  the  muscles  the  oesophagus  which  lies  on  the  left  side 
of  the  trachea  can  easily  be  distinguished.  The  incision  made  in  the 
oesophagus  should  only  be  large  enough  to  allow  the  removal  of  the  foreign 
body.  After  the  extraction  of  the  foreign  body,  the  wall  of  the  oesopha- 
gus should  be  sewed  up  with  cat-gut,  and  the  muscles  sewed  with  silk 
and  the  skin  either  left  open  or  a  drainage-tube  placed  in  it.  The  ojxjning 
is  then  treated  as  an  ordinary  wound.  No  food  must  be  given  for  48 
hours,  then  only  water  or  milk.  The  animal  should  be  kept  on  liquid  food 
for  at  least  two  weeks.  When  a  large  portion  of  the  oesophageal  wall  is 
lost,  that  which  is  sloughed  from  necrosis,  and  the  edges  of  the  wound  in 
the  oesophagus  cannot  be  brought  together,  the  case  is  hopeless. 

Other  Diseases  of  the  (Esophagus. 

In  very  rare  instances  we  find  inflammation  of  the  oesophagus  (oesoph- 
agitis) .  In  this  case  it  is  due  to  the  action  of  caustic  poisons  or  a  lacer- 
ation cavised  by  foreign  bodies  going  down  the  tube  or  from  foreign  bodies 
becoming  imbedded  in  the  tube  for  a  time  and  then  dislodged,  l:)y  injuries 
to  the  wall  from  the  probang,  and  in  still  more  rare  instances  from  swallow- 
ing hot  or  scalding  food,  by  spread  of  inflammatory  process  from  the 
pharynx,  or  the  presence  of  parasites  (spiroptera).  Oesophagitis  is  recog- 
nized l)y  great  salivation,  difficulty  in  swallowing,  attempts  at  or  true 
vomiting  and  great  pain  shown  by  the  animal  on  manipulation  of  the 
oesophagus.  The  treatment  consists  in  giving  liquids,  gruel  or  rice  water 
and  in  severe  cases,  small  pieces  of  ice  at  frequent  intervals. 

Obstructions  of  the  (Esophagus. 

(Ste nos is  Q^suphagus . ) 

This  may  result  from  the  subsequent  irritation  and  cicatricial  contrac- 
tion of  the  wall  as  a  result  of  laceration  by  a  foreign  body.  Occasionally 
we  may  find  malformation  of  the  wall  by  an  inflammatory  process  of  the 
same,  from  cyst  formations,  due  to  presence  of  spiroptera  sanguinolenta, 


SPIROPTERA   SANGUINOLENTA  {encysted  in  the  oesophagus.) 


PARALYSIS  OF  THE  (ESOPHAGUS  51 

which  grow  between  the  muscles  and  muscuhir  coat  of  the  oesophagus 
(see  Fig.  26  and  Phite),  or  by  a  compression  stenosis,  from  malignant 
goitre,  and  still  less  frequently  by  cicatricial  contraction  as  a  result  of 
injuries,  inflammations,  etc.,  in  the  cervical  region.  The  symptoms  of 
such  injuries  have  been  already  described  on  page  49.  In  cases  where 
the  stenosis  gradually  develops,  the  animal  has  more  or  less  difficulty 
in  swallowing.  This  becomes  more  and  more  difficult  until  finally  food 
collects  in  a  sausage-like  mass,  against  the  constriction.  Examination 
by  means  of  a  probang  makes  a  diagnosis  more  certain.  The  successful 
treatment  of  such  a  condition  can  only  be  expected  if  the  cause  is  due  to 


Spiroptera    Sanguinolenta. 


the  obstruction  of  the  oesophagus  by  foreign  bodies  or  the  removal  of 
tumors  if  they  should  be  the  cause  of  compression  in  the  region  of  the 
oesophagus. 

Dilatation  of  the  (Esophagus ;  Ectasia  and  Diverticulum. 

This  has  been  described  liy  a  number  of  authors  and  is  indicated  by 
great  difficulty  in  swallowing,  vomiting,  etc.  If  the  dilatation  is  in  the 
cervical  region,  along  the  line  of  the  oesophagus,  we  find  round  elongated 
lumps,  varying  in  size,  and  by  manipulation  this  collection  of  food  can  be 
worked  down  into  the  stomach.  The  probang  may  be  used  to  start  it. 
Great  care,  however,  should  be  taken  not  to  use  too  great  force,  as  it  will 
only  pack  the  food  and  fix  it.  The  prognosis,  as  a  rule,  is  unfavorable, 
but  if  the  animal  is  kept  on  liquid  food  exclusively,  it  will  li-^e  for  a  long 
time. 

Paralysis  of  the  CEsophagus. 

{Dysphagia  Paralytica.) 

This  is  due  to  the  paralysis  of  the  nerves  that  supply  the  region  of  the 
neck,  seen  particularly  in  conjunction  with  paralysis  of  the  larynx. 
It  may  occur  as  a  result  of  certain  brain  diseases,  from  certain  poisons, 
from  intestinal  mycosis,  and  also  as  a  symptom  of  rabies.  It  is  recognized 
by  constant  dribbling  of  saliva  from  the  mouth.  The  animal  may  make 
efforts  to  drink  water,  but  while  the  movements  of  the  muscles  of  the  neck 
would  lead  you  to  think  the  animal  was  doing  so,  on  close  observation  of 


52  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

the  vessel   from  which   the  animal  was   drinking,  it  shows  little  or  no 
diminution  in  the  contents. 


DISEASES  OF  THE  STOMACH. 

Acute  Catarrh  of  the  Stomach. 
Gastritis  Catarrhalis;  Gastricismus;  Acute  Dyspepsia. 

Etiology. — The  following  are  generally  the  causes  of  this  very  common 
disease:  hot,  frozen,  fermenting  or  decaying  alimentary  matters,  over- 
feeding or  gorging  after  a  long  fast,  foreign  bodies,  such  as  sand,  stones, 
buttons,  splinters  of  w^ood,  and  undigestible  food  that  is  not  adapted  or 
intended  to  be  eaten  by  dogs,  and  also  from  the  presence  of  parasites. 
As  regards  toxic  gastritis,  that  will  be  taken  up  later  on.  We  find  also 
that  some  diseases,  such  as  distemper,  some  affections  of  the  liver,  and 
intestinal  catarrh  have  acute  gastritis  accompanying  them.  Very  often 
acute  catarrh  of  the  stomach  is  developed  from  simple  colds,  or  clipping 
the  animal,  too  frequent  bathing,  and  not  drying  it  properly. 

Pathological  Anatomy. — The  mucous  membranes  of  the  stomach  are 
hyperaemic  and  swollen;  the  folds  of  the  membranes  are  distended  and 
covered  with  a  thick  tenacious  mucus.  At  times  there  are  seen  small, 
hemorrhagic  erosions  on  the  membrane. 

Clinical  Symptoms. — The  first  symptom  of  acute  catarrh  is  loss  of 
appetite.  The  animal  will  be  very  dainty  and  pick  out  certain  pieces, 
generally  meat,  and  eat  them  slowly,  or,  as  is  generally  seen,  refuse  food 
altogether.  The  animal  is  always  very  thirsty,  drinking  large  quantities 
of  water.  The  animal  vomits  frequently,  especially  after  eating  or  drink- 
ing, but  may  vomit  without  anything  on  the  stomach.  If  after  eating,  it 
consists  of  masses  of  undigested  food  mixed  with  a  tenacious  mucus  and 
saliva;  if  after  drinking  water,  the  water  is  tenacious  and  forms  bubbles  of 
thick  mucus — this  may  be  streaked  with  blood  or  more  or  less  tainted 
with  bile,  according  to  the  condition  of  the  liver.  The  tongue  is  coated 
with  a  thick,  white  mucus  and  on  pressure  in  the  region  of  the  stomach 
the  animal  evinces  pain,  and  the  stomach  may  be  distended  with  gas  (see 
page  20).  The  animal  is  irritable  and  wants  to  keep  in  the  dark  or 
in  cool  places  and  not  be  disturbed,  or  may  give  sharp  short  cries, 
change  from  place  to  place,  and  give  every  indication  of  stomachache. 
The  nose  is  dry  and  the  body  temperature  uneven,  that  is,  body  hot,  ex- 
tremities cold,  and  there  may  be  some  rise  of  temperature.  If  the  symp- 
toms are  of  an  alarming  character,  they  are  generally  caused  by  some 
toxic  condition,  due  to  the  formation  of  poisons,  generated  in  the 
stomach  (ptomains).  With  this  we  have  a  putrid  smell  from  the  mouth, 
great  depression,  or  even  complete  coma,  and  evidences  of  acute  narcotic 


CHRONIC  CATARRH  OF  THE  STOMACH  53 

poisoning.  See  chapter  on  Mycotic  Stomatitis,  Catarrh  of  the  Intestines, 
and  Inflammatory  Hemorrhagic  Gastro-cnteritis. 

There  are  always  some  intestinal  complications.  There  is  increased 
excretion  of  faeces,  generally  diarrhoea,  and  occasionally  icterus  of  a 
catarrhal  nature.  The  animal,  as  a  rule,  makes  a  good  recovery.  In 
very  rare  cases  the  condition  becomes  chronic,  but  death  never  occurs 
except  where  some  complication  other  than  true  catarrh  of  the  stomach, 
is  present. 

Therapeutics. — The  treatment  differs  according  to  the  exciting  cause, 
and  also  the  severity  of  the  symptoms.  If  the  cause  has  been  the  eating 
of  some  putrid  matters  and  if  you  suspect  some  to  be  present  in  the  stom- 
ach, it  is  best  to  give  the  animal  an  emetic,  such  as  the  hypodermatic  in- 
jection of  apomorphia,  as  described  on  page  21;  such  emetics  as  tartar 
emetic,  ipecacuanha  or  antimonial  wine  are  not  advised,  they  are  all 
very  depressing.  After  the  animal  vomits  and  the  vomited  matter  is 
putrid  and  offensive  matter,  it  is  well  to  give  the  animal  8  to  10  ounces 
of  warm  water  with  a  small  cjuantity  of  bicarbonate  of  soda  in  it.  It  is 
good  practice  to  add  a  little  creolin  to  the  warm  water.  If  it  is  not  ad- 
visable to  administer  emetics  in  such  cases  where  the  animal  is  greatly 
depressed,  calomel  or  Glauber  salts  can  be  given  to  sweep  the  intestinal 
tract.  Keep  the  animal  on  a  low  diet  in  the  beginning;  let  the  animal 
do  without  food  for  a  day,  and  then  give  small  cpiantities  of  milk  or 
finely  cut-up  meat,  soup,  or  beef  tea,  a  stomachic,  such  as  tincture  of 
rhubarb  or  nux  vomica  in  small  doses;  if  there  is  vomiting,  carbonate 
of  sodium  or  magnesium  is  to  be  given  in  small  doses  several  times 
daily.  Essence  of  pepsin  is  also  useful  to  settle  the  stomach;  it  must 
be  given  in  teaspoonful  doses  three  times  daily. 

Chronic  Catarrh  of  the  Stomach. 
Gastritis  Catarrhalis  Chronica;  Chronic  Dyspepsia. 

Etiology. — Chronic  dyspepsia  is  rather  common  in  the  dog,  especially 
if  the  aninuil  has  had  several  attacks  of  acute  dyspepsia.  It  may  also  ap- 
pear as  a  secondary  complication  of  various  diseases,  such  as  chronic  dis- 
ease of  the  liver,  lung  or  heart,  cancer  of  the  stomach,  gastric  tumors,  and 
parasites. 

Pathological  Anatomy. — The  mucous  membrane  is  covered  with  a 
tough,  glassy  mucus,  dirty-white  in  color.  In  the  early  stages  the 
mucous  membrane  is  red,  and  as  the  disease  continues  the  membrane 
becomes  dark  gray  in  color,  due  to  pigment  stains  and  more  or  less  swol- 
len, especially  if  the  gastric  glands  become  atrophied  and  indurated 
from  the  constant  irritation. 

CUnical  Symptoms. — They  are  similar  to  those  of  the  acute  catarrh 


54  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

of  the  stomach;  Init  the  appetite,  while  it  may  be  very  irregular,  is  not  en- 
tirely absent — one  day  very  good  and  the  next  absent.  Vomiting  oc- 
curs generally  a  short  time  after  eating,  and  consists  of  undigested  food 
covered  with  quantities  of  tough,  glassy  mucus,  sometimes  streaked  with 
blood,  and  the  tongue  is  more  or  less  coated.  There  is  pain  on  pressure  in 
the  region  of  the  stomach,  especially  after  eating,  although  this  is  not  a  con- 
stant symptom  by  any  means.  The  animal  becomes  thin  and  shows  every 
S3^mptom  of  poor  nutrition. 

We  must  always  take  into  consideration  that  the  mere  loss  of  ap- 
petite does  not  always  mean  acute  or  chronic  catarrh  of  the  stomach,  but 
is  a  symptom  present  in  a  number  of  pathological  conditions,  and  every 
symptom  must  be  carefully  examined  before  coming  to  a  definite 
conclusion. 

Therapeutics. — The  washmg  out  of  the  stomach,  so  often  resorted  to  in 
man,  is  fully  explained  on  page  21.  This  treatment  is  not  to  be  employed 
in  all  cases  of  this  disorder;  for  in  some  cases  it  produces  great  irritation, 
and  if  persisted  in  does  more  harm  than  good.  Try  to  get  the  animal  to 
drink  small  portions  of  water,  Avith  some  lime  water  in  it,  at  frec|uent  in- 
tervals; if  it  will  not  drink,  pour  fresh  water  down  its  throat;  in 
anaemic  animals,  use  tepid  water,  with  a  small  ciuantity  of  a  solution  of 
bicarbonate  of  sodium,  a  pinch  or  a  teaspoonfid  of  Carlsbad  salt,  in  warm 
water,  on  an  empty  stomach.  Hydrochloric  acid  well  diluted  can  be 
given  after  meals  and  the  treatment  described  on  page  53.  In  very 
acute  cases  give  naphthaline,  salic3'lic  acid,  I'csorcin,  menthol,  or  thymol. 
As  a  rule,  however,  it  is  advisable  not  to  do  this  unless  you  suspect  some 
irritant  or  poisonous  material  to  be  present.  If  the  chronic  catarrh 
occurs  as  a  result  of  other  diseases,  we  must  treat  the  original  cause, 
as  very  frequently  when  the  other  disease  is  treated  successfully,  the 
gastric  mucous  membrane  returns  to  its  natural  condition  without  any 
other  treatment. 

I>      Extract!  rhei;  2.0 

Sodii  bicarhouatis,  100.0 

M. 
Sig. — A  small  pinch  twice  daily. 

I^      Mentholis,  2.0 

Sacchari  lactis, 

Guinmi  arahic,  aa  1.0 

M.   Et  fiat  pulv.,  No.  x. 
Sig. — Give  one  twice  daily. 

Other  Disorders  of  the  Stomach. 

Expansion  or  Dilatation  of  the  Stomach  (Gastrectasis ,  Dilatatio  Ven- 
tricuU) . — This  condition  may  occur  in  the  acute  or  chronic  form.  In  acute 
it  is  due  to  overloading  the  stomach  with  dry  food  and  particularly  when 


OTHER  DISORDERS  OF  THE  STOMACH  55 

the  food  is  of  a  poor  indigestible  character.  If  the  stomach  is  not 
emptied  by  an  emetic,  the  abdomen  becomes  greatly  distended,  particu- 
larly in  the  epigastric  region.  The  animal  is  restless,  moving  from  one 
place  to  another,  the  expression  is  haggard  and  indicates  pain,  there  is 
quick  catchy  respiration,  and  the  pulse  greatly  increased  in  number. 
In  severe  cases  the  animals  die  with  dyspnoea.  In  less  acute  cases  the 
animals  slowly  recover  or  it  is  followed  by  an  attack  of  acute  gastric 
catarrh. 

The  treatment  consists  in  administration  of  an  emetic,  such  as  a 
hypodermic  of  apomorphia. 

A  chronic  dilatation  of  the  stomach  is  frequently  seen  in  dogs  that 
are  fed  on  poor  food  and  in  animals  that  gulp  down  their  food,  partic- 
ularly when  they  are  only  fed  once  daily.  It  may  also  occur  from  contrac- 
tion of  the  pyloric  end  of  the  stomach  or  duodenum,  from  cicatricial  con- 
traction, the  presence  of  carcinoma,  or  from  weakness  of  the  walls  of  the 
stomach;  this  latter  condition  is  rarely  seen.  In  chronic  dilatation  of 
the  stomach  there  are  all  the  indications  of  chronic  catarrh  with  more  or 
less  distention  of  the  abdomen,  particularly  in  the  epigastric  region. 
On  percussion  of  the  region  of  the  stomach  a  dull  tympanic  sound  is 
heard,  which  disappears  when  the  animal  eats  any  food;  then  palpation 
of  the  stomach  produces  a  splashing  sound. 

The  treatment  consists  in  giving  the  animal  smaller  quantities  at 
shorter  intervals  and  the  same  medical  treatment  as  is  advised  under 
chronic  dyspepsia.  If  it  is  suspected  or  diagnosed  that  there  is  pyloric 
stenosis,  you  should  try  to  remove  it  by  surgical  means. 

Reversion  or  Inverted  Stomach,  Torsio  Ventriculi,  Volvulus  Ventric- 
uli. — This  is  observed  where  the  stomach  is  turned  on  its  axis  and,  as  a 
rule,  occurs  in  the  larger  breeds  of  dogs.  The  stomach  is  completely  re- 
versed, so  that  the  pyloric  end  is  found  in  the  left  epigastric  region  instead 
of  the  right,  and  the  large  curvature,  instead  of  being  on  the  left,  is  found 
on  the  right  and  the  oesophagus  has  a  twist  in  it.  On  making  an  ab- 
dominal incision  the  stomach  is  found  to  be  greatly  distended  and  the 
spleen  is  greatly  enlarged.  The  causes  that  may  produce  this  condition 
are  violent  exercise,  particularly  running  up  and  down  steps  with  an 
empty  stomach  (Cadiac) ,  or  the  same  exercise  with  a  greatly  distended 
stomach  (Jensen) .  The  symptoms  come  on  very  quickly,  great  distention 
of  the  abdomen,  dyspnoea,  cyanosis,  pain  on  pressure  of  the  region  of  the 
stomach,  colicky  pains  and  vomiting.  Death  generally  occvirs  in  from  30 
to  40  hours,  either  by  suffocation  or  paralysis  of  the  heart.  The  treat- 
ment recommended  by  Cadiac  is  to  gradually  remove  the  gas  from  the 
stomach  by  means  of  a  trocar  and  opening  the  abdomen  and  returning 
the  stomach  to  its  original  position. 

Foreign  Bodies  in  the  Stomach. — By  this  we  mean  stones,  glass, 


56 


DISEASES  OF  THE  DIGESTIVE  APPARATUS 


balls,  pieces  of  money,  rubber  balls,  needles,  hair  balls.  These  produce 
the  following  symptoms:  vomiting,  loss  of  appetite,  restlessness,  animal 
screaming  with  pain  or  howling,  animal  attempts  to  bite  all  who  touch 
him,  colic  and  in  the  later  stages  great  depression;  where  foreign  bodies 
become  lodged  in  the  pyloric  portion  of  the  stomach  (see  Fig.  27)  there 
may  be  no  other  symptom  than  acute  catarrh  of  the  stomach.  We  may 
detect  the  foreign  bodies  by  palpation  or  by  means  of  the  Rontgen  or 
X-rays. 


Fig.  27. — X-ray  picture  of  coin  in  the  stomach. 


Therapeutics. — If  the  foreign  body  is  diagnosed,  give  an  emetic. 
Moller  advises  giving  a  good  meal  before  the  emetic  is  administered  so 
as  to  assist  in  holding  the  foreign  body  when  the  emesis  occurs  and  this 
prevents  it  doing  any  harm  to  the  tissues.  If  the  emetic  does  not  succeed 
in  removing  the  foreign  body,  laparogastrotomy  must  be  performed. 
This  is  described  in  detail  under  that  head  later.  In  performing  that 
operation  for  this  particular  case,  the  incision  should  be  made  on  the  linea 
alba  close  up  to  the  xyphoid  cartilage  and  thus  bring  the  incision  close 
and  parallel  to  the  great  curvature  of  the  stomach;  or,  as  Frick  advises,  on 
the  diaphragmatic  position  of  the  stomach  directly  on  the  great  curva- 
ture. In  this  operation,  great  care  must  be  taken  not  to  cut  any  of  the 
large  arteries  of  the  stomach,  which  are  located  on  the  great  curvature. 


OTHER  DISORDERS  OF  THE  STOMACH  57 

The  animal  must  be  fed  on  the  lightest  of  liquid  food  for  at  least  a  week 
after  the  operation 

Ulceration  of  the  Stomach  (Ulcus  Ventriculi). — When  bleeding  occurs 
from  the  stomach  as  the  result  of  some  acute  inflammatory  condition  of 
that  organ,  it  always  leaves  an  erosion  of  the  mucous  membrane.  As  a 
rule,  this  heals  up  very  rapidly  in  the  dog,  rarely  leaving  any  cicatrix  on 
the  membrane;  abrasions  of  the  mucous  membrane  from  sharp  pieces  of 
bone,  splinters,  or  caustic  agents  also  heal  up  very  rapidly. 

Ocasionall}^,  however,  we  see  true  ulceration  of  the  stomach.  The 
real  cause  of  this  condition  has  not  yet  been  satisfactorily  explained, 
although  many  investigations  have  been  made  on  the  subject. 

The  ulcer  in  the  beginning  is  an  inflamed  circular  spot,  from  which 
the  mucous  membrane  peels,  and  gradually  disappears,  extending  to  the 
deeper  tissues  where  it  forms  a  yellowish-red,  unhealthy  surface,  with  an 
irregular,  hard,  indurated  border.  Very  often  they  heal  up,  leaving  an 
irregular  cicatrix,  usually  circular  in  shape. 

In  the  dog,  as  in  man,  we  find  that  in  rare  instances  the  ulceration  is 
so  extensive  as  to  perforate  the  stomach  to  the  serous  membrane  and 
form  adhesions  to  the  adjacent  organs. 

This  condition  may  be  present  without  presenting  any  symptoms 
that  can  be  recognized,  and  it  is  only  on  post-mortem  that  it  is  rec- 
ognized, either  by  the  presence  of  the  ulcer,  or  a  cicatrix  is  seen  on  the 
mucous  membrane  of  the  stomach.  The  symptoms  recognized  are 
generally  those  of  gastric  catarrh,  with  vomiting  of  blood  at  irregular 
intervals.  The  treatment  consists  in  administering  bicarbonate  of 
sodium,  argenti  nitras  or,  better,  some  of  the  organic  compounds  of 
silver,  or  subnitrate  of  bismuth  is  useful,  but  the  use  of  hydrochloric 
acid  or  a  stomach-pump  is  contraindicated. 

Cancer  of  the  Stomach :  Carcinoma  Ventriculi. — Cancer  of  the  stom- 
ach is  very  rare.  Symptoms  consist  of  irregular  attacks  of  gastric  catarrh 
with  possibly  vomiting  and  gradual  loss  of  flesh,  and  if  the  carcinoma  is 
located  in  the  pyloric  end  of  the  stomach,  we  would  be  apt  to  find  pyloric 
stenosis  and  dilatation  of  the  stomach.  Eberlin  describes  a  case  in  which 
a  carcinoma  was  present  in  the  pylorus  and  duodenum  and  accompanied 
with  acute  icterus.  It  is  almost  impossible  to  detect  with  any  degree  of 
certainty  such  a  cancer  by  palpation.  Parascandolo  performed  gas- 
trectomy and  removed  a  cancer  from  the  stomach  with  complete  success. 

Parasites  of  the  Stomach. — The  spiroptera  sanguinolenta  is  fre- 
quently the  cause  of  stenosis  of  the  cesophagus  (see  Fig.  20  and  Plate). 
In  the  adult  form  this  parasite  is  from  3  to  7  cm.,  the  male  3  to  4  and  the 
female  6  to  7  cm.,  and  are  blood  red  in  color.  They  may  be  solitary,  or 
several  may  occur  in  one  ulcer.  This  nodule  is  frequently  the  size  of  a 
pigeon's  egg.      The  parasite  is  found  in  the  submucous  tissue   with  a 


58  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

small  opening  into  the  stomach.  In  rare  instances,  this  parasite  is  found 
in  the  bronchial  glands,  the  aortic  wall,  in  the  lungs,  and  in  the  neighbor- 
hood of  the  kidneys  (Railliet).  The  general  symptom  of  these  parasites 
in  the  stomach  is  a  catarrh  of  the  stomach,  gradual  emaciation  and 
sometimes  great  restlessness.  Hunter  describes  a  dog  who  was  greatly 
emaciated  and  was  destroyed  as  suspected  of  having  rabies.  On  post- 
mortem, the  mucous  membrane  of  the  stomach  was  very  much  congested, 
and  he  found  six  nodules  the  size  of  a  walnut,  in  which  there  were 
numerous  spiroptera  sanguinolenta. 

Very  rare  instances  are  found  where  the  larvae  of  the  Gastrophilus 
equi  are  found  in  the  mucous  membrane  of  the  dog.  The  egg  may  have 
been  deposited  in  the  hair  of  the  dog,  and  by  being  licked  off  by  the 
animal,  reached  the  stomach  or,  from  depraved  appetite,  the  animal  ate 
horse  droppings.  This  mode  of  transfer  was  done  experimentally  by 
Railliet. 

DISEASES  OF  THE  INTESTINES. 

Intestinal   Catarrh. 

(Catarrh  of  the  Bowels;  Enteritis  Catarrhalis.) 

Catarrh  of  the  intestines  originates  freciuently  from  the  same  causes 
as  catarrh  of  the  stomach,  when  the  animal  has  eaten  some  irritating  sub- 
stance, and  it  frequently  happens  that  the  two  diseases  occur  together. 

Intestinal  catarrh  is  generally  caused  by  the  animal  eating  decayed, 
tainted,  fermenting,  or  indigestible  food,  or  from  intestinal  parasites  or 
poisons.  It  also  appears  in  an  infectious  form,  attacking  entire  kennels 
and  animals  of  all  ages.  It  is  freciuently  caused  by  cold  or  certain  in- 
fectious diseases  and  sympathetically  in  other  disturbances  of  the  in- 
testinal tract,  such  as  distemper,  septicaemia  from  disturbances  of  the 
circulation  and  from  disorders  of  the  liver,  lungs,  heart.  Coccidia  are 
supposed  to  cause  this  disease,  but  the  waiter  never  found  but  one  case 
in  all  his  observations;  in  this  one  case  the  animal  was  greatly  emaciated. 

According  to  the  duration  and  severity  of  the  disease,  we  determine 
whether  we  have  acute  or  chronic  catarrh  of  the  intestines.  The  acute 
form  of  the  disease  lasts  from  one  to  two  weeks;  the  chronic  often  for 
months. 

Etiology. — The  causes  of  acute  and  chronic  catarrh  in  the  intestines 
are  similar;  the  latter  is  frequently  developed  from  the  acute  form  and 
from  frequent  return  of  the  disease,  the  system  becomes  weakened  and 
the  disease  remains  in  a  milder,  but  chronic  form. 

The  disease  may  be  located  cither  in  the  small  or  large  intestines,  or 
in  both.     The  small  intestine  is  the  common  seat  of  the  disease,  but  it  is 


INTESTINAL  CATARRH  59 

frequently  found  also  in  the  large  intestines.  The  various  classifications, 
such  as  duodenitis,  jejunitis,  ileitis,  typhlitis,  colitis  and  proctitis,  are 
useful  only  to  the  anatomist,  but  not  to  the  observer.  Proctitis  is  fre- 
quently seen  in  the  dog  in  an  isolated  form.  This  is  given  with  more 
detail  on  page  25. 

Pathological  Anatomy. — The  effects  of  catarrh  of  the  intestines  are 
practically  the  same  as  in  all  irritations  of  the  mucous  membranes.  In 
the  acute  form,  the  membranes  may  be  swollen  and  reddened  through  the 
entire  intestine,  or  it  may  be  confined  to  certain  localities,  where  it  is 
reddened  and  congested,  and  the  membrane  raised  and  covered  over  its 
surface  with  flaky,  slimy  epithelium.  In  very  bad  cases  there  is  a  large 
number  of  these  epithelial  masses,  with  desquamation  of  the  mucous 
membrane.  These  masses  of  inflamed  follicles  become  grayish-white 
in  color  and  project  from  the  membrane  or  finally  become  ulcerated.  In 
some  diseases,  where  there  is  severe  catarrhal  inflammation  of  the  mucous 
membranes,  we  find  a  sympathetic  inflammation  of  the  intestine,  in 
some  cases  even  a  necrosis  from  which  follows  ulceration  of  the  bowel. 
The  writer  had  one  case  under  his  observation,  where  a  young  dog  died 
from  a  necrotic  vdceration  of  the  bowels. 

In  the  chronic  form,  the  redness  is  less  intense;  the  mucous  mem- 
brane may  even  be  pale  or  livid,  grayish-red  or  dark  red  in  color.  In  rare 
cases  it  is  slate  color.  The  swelling  is  more  regular  and  covers  a  larger 
area,  forming  a  true  hyperplasia  of  the  membrane;  the  inner  surface 
of  the  bowel  becomes  irregular  and  uneven  w'ith  projections  over  the 
entire  surface.  In  some  cases  the  membrane  shows  true  polypous  forma- 
tions, due  to  circumscribed  hyperplasia  of  the  connective  tissues.  AVhere 
there  has  been  cystoid  degeneration  of  the  follicles,  the  intestinal  secre- 
tions are  stopped  entirely  and  the  mucous  membrane  is  thin  and  smooth. 

Clinical  Symptoms. — The  most  prominent  symptom  of  intestinal 
catarrh  is  diarrhoea,  especially  if  it  is  confined  to  the  large  intestine, 
although  there  may  l)e  no  diarrhoea  whatever  if  the  inflammation  is  con- 
fined to  the  small  intestine,  as  it  is  well  known  that  the  absorption  of  the 
fluids  and  the  formation  of  the  faeces  are  confined  to  the  large  intestine, 
and  we  often  find  intense  inflammation  of  the  small  intestine  with  pro- 
fuse diarrhoea  without  having  the  large  intestine  affected  whatever. 
On  the  other  hand,  we  often  find  inflammation  of  the  rectum  and  no 
diarrhoea  at  all. 

In  making  a  diagnosis  it  is  well  not  to  identify  too  closely  diarrhoea 
and  catarrh  of  the  intestines — that  is,  consider  each  case  of  diarrhoea  as 
being  due  to  catarrh  of  the  bowels — as  there  are  many  conditions  that 
increase  the  peristaltic  action  and  cause  diarrhoea  that  are  not  directly 
due  to  inflammation,  such  as  cold  or  a  sudden  chill,  to  an  animal  that  has 
been  kept  warm,  to  poisonous  substances,  from  the  administration  of 


GO  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

laxatives  or  cathartics,  or  great  exertion  in  an  animal,  not  accustomed  to 
it.  It  is,  however,  impossible  to  draw  a  distinct  line  between  intestinal 
catarrh  and  diarrhoea,  but  a  conclusion  can  be  arrived  at  by  the  number, 
amount,  and  character  of  the  diarrhoeic  discharges. 

The  number  of  stools  varies,  to  a  certain  extent,  and  their  consist- 
ency, from  pulpy  to  thin,  water  evacuations.  At  first  the  passages  are 
clearer  than  natural,  and  yellower,  and  as  the  condition  goes  on  they 
become  gray;  this  color  is  due  to  the  fact  that  the  passages  are  so  frequent 
that  the  liver  is  not  able  to  furnish  sufficient  bile  to  color  them,  and  in  a 
number  of  cases,  there  is  a  certain  amount  of  thick  gelatinous  mucus 
mixed  in  the  excremental  matter.  In  some  cases  the  mucus  becomes 
very  copious,  and  sometimes  the  passages  are  nothing  but  mucus,  fre- 
quently frothy,  the  stool  being  filled  with  small  bubbles  of  gas  and  an 
intensely  offensive  odor,  and  in  rare  cases  blood  and  pus  are  present;  for 
further  details  see  page  27. 

In  intestinal  catarrh  the  animal  is  restless,  changing  its  position 
frequently,  groans  or  cries,  arches  the  back,  or  may  rest  the  forepart  of 
the  body  on  the  ground  and  have  the  hind  quarters  elevated.  This  is  an 
indication  of  colicky  pains.  The  examination  of  the  abdomen  externally 
does  not  furnish  much  information.  Sometimes  the  abdomen  is  drawn 
up;  in  other  cases  it  is  distended.  On  applying  the  ear  to  the  region  of 
the  abdomen,  a  great  amount  of  gurgling  or  rolling  is  heard  in  the  cavity; 
this  may  often  be  heard  quite  distinctly  some  distance  from  the  animal. 
This  is  due  to  the  increased  peristaltic  action.  On  pressing  the  posterior 
part  of  the  abdomen,  the  animal  often  evinces  pain. 

Tenesmus  and  relaxation  of  the  rectum  are  generally  present  in  the 
later  stages  of  this  disease.  The  animal  makes  prolonged  and  repeated 
efforts  to  pass  the  excremental  matter,  and  finally  passes  only  small 
amounts  of  mucus  and  blood,  after  great  exertion.  In  some  cases  these 
prolonged  exertions  cause  the  lower  bowel  to  be  protruded.  This, 
however,  is  generally  seen  in  young  puppies  and  only  in  very  rare  in- 
stances in  older  dogs.  If  the  tenesmus  is  very  great,  it  indicates  that 
there  is  great  irritation  of  the  lower  bowel  (as  regards  the  examination  of 
the  lower  bowel,  see  page  28). 

The  other  symptoms  of  catarrh  of  the  intestines  are  as  follows:  The 
color  of  the  urine  becomes  dark  from  the  tinting  of  the  bile  pigment  and 
is  lessened  in  quantity  from  the  drain  of  fluids  from  the  bowels.  Fever 
is  present,  but  it  is  generally  slight.  There  is  loss  of  appetite,  vomiting, 
and  yellow  or  icteric  coloring  of  the  mucous  membranes,  great  thirst,  and 
the  animal  becomes  weak  very  quickly  and  shows  great  depression.  This 
is  specially  noticeable  when  the  inflammation  is  due  to  eating  decayed 
meat. 

Chronic   catarrh  of  the  bowels  resonil)los  the  acute  form  in  many 


INTESTINAL  CATARRH  61 

ways,  but  it  is  less  severe  in  its  symptoms.  The  faeces  change  from  soft 
to  firm,  like  the  stools  of  cliarrhcEa,  and  vice  versa,  the  animal  becoming 
weak  and  thin,  showing  signs  of  anaemia;  but  in  the  chronic  cases  the  ap- 
petite is  generally  very  good.  In  some  cases  where  the  disease  has  been 
present  a  long  time,  when  we  examine  the  intestines  by  palpation,  through 
the  abdominal  wall,  the  intestines  are  found  to  be  firmer  and  less  elastic. 

Prognosis. — In  strong  animals,  this  disease  is  generally  not  very  se- 
rious, but  in  young  dogs  or  puppies,  it  causes  great  exhaustion  and  they 
die  from  collapse  before  the  diarrhoea  can  be  checked;  the  chronic  form 
in  old  animals  is  generally  very  hard  to  control  and  must  be  looked  upon 
as  a  grave  condition.  Often  attacks  follow  one  after  the  other,  com- 
pletely prostrating  the  animal  and  carrying  it  off  finally. 

Therapeutics. — In  slight  cases  the  only  thing  to  do  is  to  keep  the 
animal  in  an  even  warm  temperature,  regulate  the  food  and,  as  a  rule, 
lessen  it  in  quantity  and  make  it  easier  digested.  Soup  or  broth,  mixed 
with  bread  or  biscuit,  rice,  etc.,  friction  to  the  stomach  and  a  small  quan- 
tity of  alcohol,  in  the  form  of  whiskey  or  sherry,  for  weak,  delicate  dogs. 
It  must  be  borne  in  mind  that  in  all  cases  of  this  disease  the  treatment 
will  depend  entirely  on  the  causes  and  symptoms  that  are  observed.  If 
the  cause  has  been  the  ingestion  of  decayed  or  putrid  substances,  or 
internal  parasites,  the  first  thing  to  do  is  to  clean  the  intestinal  canal 
out  by  means  of  a  purgative,  such  as  calomel,  Glauber  salt,  or  in  weak 
subjects  or  puppies,  olive  oil.  If  there  is  any  indication  that  the  liver  is 
disturbed,  it  is  best  to  first  administer  a  dose  of  calomel  and  follow  up 
with  a  saline  purgative.  Where  there  are  copious  and  thin  discharges 
and  an  indication  of  excessive  peristaltic  action,  laxatives  are  contra- 
indicated;  it  is  advisable  to  use  narcotics,  and  in  this  instance  opium  is 
always  indicated,  powdered  opium,  laudanum,  morphia  or  Dover's  pow- 
ders. The  attempt  to  substitute  extract  of  belladonna  or  hyoscyamus 
and  bromide  of  sodium  in  this  disease  has  not  proved  to  be  very  success- 
ful. Beside  opium,  we  should  also  use  the  true  astringents,  such  as  tannic 
acid,  calumbo  root,  and  cascarilla  bark.  Certain  preparations  of  bis- 
muth have  a  tendency  to  disinfect  the  intestinal  canal  and  also  to  soothe 
the  irritated  mucous  membranes.  Xeroform  (bismuth  tribomphen- 
yticum)  or  bismuth  subgallate  or  subnitrate.  If  ulceration  of  the  bowels 
is  indicated  by  symptoms,  the  albuminoid  or  organic  preparations  of 
silver  or  nitrate  of  silver  are  to  be  given,  followed  up  by  small  doses  of 
naphthalin,  salicylic  acid  or  creosote.  If  we  suspect  that  there  is  a  certain 
amount  of  putrid  matter  in  the  intestines  beside,  use  saline  laxatives  to 
sweep  out  the  decayed  material;  after  doing  this  administer  xeroform  or 
resorcin  (see  treatment  of  mycotic  gastro-enteritis) .  It  is  well  to  make 
one  or  two  irrigations  of  the  bowels  daily  by  means  of  a  rubber  funnel 
and  a  piece  of  rubber  hose  with  a  pipe  of  hard  rubber  at  the  end,  which 


62  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

is  inserted  in  the  rectum,  as  far  as  possible,  and  the  fluid  poured  into  the 
funnel  and  allowed  to  gravitate  slowly  into  the  bowel.  The  best  solu- 
tions to  use  are  a  1  to  2  per  cent,  solution  of  tannin,  alum,  or  1/2  to  1 
per  cent,  solution  of  silver  nitrate  or  one  of  the  various  synthetical  silver 
salts  (argenol,  argyrol,  argentamine,  picratol),  the  solution  to  be  about 
30  per  cent.  The  amount  to  use  is  about  1  to  2  litres.  If  this  amount 
causes  much  irritation  and  straining,  it  must  be  discontinued;  but  it  is 
well  to  give  the  animal  at  least  one  injection  by  this  method,  as  it  helps 
to  clean  out  the  lower  bowel  and  facilitate  the  action  of  the  medicinal 
agent. 

The  treatment  of  chronic  catarrh  of  the  bowel  is  practically  the  same 
as  the  acute.  Catarrh  of  the  rectum  may  be  caused  by  an  extension  of  the 
irritant  from  the  intestines,  but  this  condition  is  more  apt  to  result  from 
mechanical  irritants,  very  hard  faeces,  sharp  splinters  of  bone  or  wood, 
rectal  parasites;  in  male  puppies  that  are  housed  with  other  older  animals, 
particularly  stud  dogs,  the  rectum  of  the  younger  dog  is  frequently 
greatly  irritated  by  attempted  copulation  on  the  part  of  the  older  male. 
Proctitis  is  recognized  by  difficult  and  painful  defecation  and  the  passage 
of  small  quantities  of  fseces  covered  with  mucus  and  frequently  bloody. 
When  making  a  diagnosis,  the  rectum  can  be  examined  by  means  of  the 
fingers  previously  oiled  and  introduced  into  the  rectum  or  by  means  of  a 
rectal  speculum.  After  removing  the  cause,  hard  fseces  or  a  foreign  body, 
inject  into  the  rectum,  by  means  of  a  clyster  apparatus  already  described, 
a  thin  mixture  of  starch  with  a  small  amount  of  opium  in  it  or  alum  or 
organic  silver  solution.  Tincture  of  nux  vomica  is  very  useful  as  a  tonic 
in  one  or  two-drop  doses,  before  meals,  twice  daily.  The  quantity  of 
food  requires  special  attention.  Give  easily  digested  food  and  of  a 
character  that  will  not  produce  a  large  amount  of  fseces;  bones,  fat,  tendi- 
nous, fibrous  meat  must  be  avoided.  In  order  to  counteract  the  loss  of 
strength,  give  small  quantities  of  rare  or  raw  meat,  finely  chopped,  milk, 
egg,  rice  and  also  the  various  peptone  preparations.  In  young  puppies 
the  various  infant  foods  so  largely  used  in  children  practice  are  used  as  a 
substitute  for  milk.  In  persistent  diarrhoea,  give  bismuth  subgallate 
subnitrate  or  salicylate  or  the  organic  compounds  of  silver.  In  rare  cases, 
where  we  find  constipation  present  use  a  saturated  solution  of  Glauber 
salt,  in  teaspoonful  doses;  Hunyadi,  Apenta  or  other  laxative  waters  may 
also  be  given.  Any  complication  of  the  stomach  will  have  to  be  treated  by 
the  method  advised  under  Catarrh  of  the  Stomach. 

The  toxic  and  mycotic  inflammations  of  the  stomach  will  be 
described  separately. 

Gastro-intestinal  Inflammation. — Gastro-enteritis  is  caused  by  the 
absorption  of  various  acids  or  irritating  substances  and  also  by  the  exces- 
sive use  of  drastic  purgatives,  such  as  aloes,  calomel,  croton  oil.     If  the 


INTESTINAL  CATARRH  63 

drug  should  be  slowly  soluble,  or  in  the  powder  form,  or  contained 
intimately  mixed  with  some  other  substance,  it  may  reach  the  small 
intestines  or  even  the  large  intestines  and  the  rectum. 

The  intensity  of  the  disease  depends  on  the  amount  of  the  drug  taken 
and  on  the  effect  it  has  on  the  mucous  membranes.  The  only  result  may 
be  an  attack  of  acute'catarrh,  with  some  loss  of  the  epithelium  of  the  mu- 
cous membrane,  or  there  may  be  also  a  gangrenous  destruction  of  the 
w^alls  of  the  stomach.  It  is  seldom  that  irritating  agents  get  any  further 
than  that  organ,  wasting  their  strength  there  and  changing  the  wall  of 
the  stomach  into  a  blackened  or  tinder-like  mass,  and  all  the  surrounding 
tissues  are  swollen  and  reddened  by  hyperaemia  or  hemorrhages. 

We  may  safely  conclude  that  we  have  a  toxic  gastro-enteritis  to 
contend  with  when  the  symptoms  of  a  serious  gastric  catarrh  appear  sud- 
denly, especially  after  eating,  and  if  the  grave  symptoms  increase  rapidly 
and  are  accompanied  by  loss  of  appetite,  salivation,  vomiting,  great 
restlessness,  severe  pains  taking  the  nature  of  colic,  and  on  pressure  on 
the  abdomen,  it  is  painful  and  greatly  distended,  the  vomited  matter  and 
the  passages  from  the  intestines  being  mixed  with  mucus  and  blood, 
tenesmus,  great  weakness  and  small  frequent  pulse. 

The  treatment  consists,  first,  in  giving  an  emetic,  or  use  a  stomach- 
pump  or  wash  the  stomach,  see  page  21,  and  after  that  has  had  its  effect, 
give  a  laxative,  an  oleaginous  one  (olive  oil  or  linseed  oil)  is  the  best, 
rectal  injections  of  warm  w^ater,  if  there  is  much  j^ain  and  irritation,  small 
quantities  of  opium  can  be  given  in  the  oil,  and  if  the  poison  can  be  dis- 
covered, use  the  proper  antidotes,  which  are  given  in  the  chapter  on 
Poisoning. 

Mycotic  Inflammation  of  the  Stomach  and  Intestines  (Gastro- 
enteritis, Mycotic  Decayed  Meat  Poisoning). — This  is  a  variety  of  toxic 
inflammation,  of  the  stomach  and  intestines.  It  is  due  to  decayed  meat 
poisoning.  This  is  seen  after  the  animal  has  eaten  decomposed  meat, 
offal  or  from  drinking  brine  (Leisering),  or  eating  cadavers  of  dogs  or  other 
animals  that  have  died  infected  with  bacteria,  i.e.,  pus,  septic  metritis, 
mastitis,  enteritis,  nephritis;  from  drinking  or  licking  the  juices  of  de- 
cayed meat,  putrified  cheese,  sausage;  fish  and  all  such  matters  that  are 
filled  with  toxincs  and  tox-albumens,  developed  from  the  micro-organ- 
isms such  materials  contain,  also  from  drinking  from  stagnant  ponds 
and  bodies  of  water  containing  decayed  substances,  or  cadavers.  This 
condition  is  seen  in  all  sorts  and  conditions  of  animals,  in  the  best  fed  and 
semi-starved,  in  the  first  from  depraved  appetite,  due  to  indigestion. 
Even  when  they  are  well  fed,  they  get  into  the  habit,  if  they  are  allowed  to 
roam  in  closely  populated  towns  and  villages,  to  go  a  regular  route  from 
one  garbage  pail  to  another  and  eat  all  sorts  of  decayed  vegetable  or 
animal  matter.     The  active  agent  has  a  toxic  principle  present  in  it.     The 


64  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

symptoms  of  that  form  of  poisoning  are  as  follows:  vomiting  of  an  amount 
of  very  offensive  matter,  rotten  masses  of  meat  and  with  it  quantities 
of  bad-smelling  mucus  and  sometimes  accompanied  by  violent  bloody 
diarrhoea,  intense  thirst  and  high  fever,  40  to  42°.  The  writer  has  seen, 
however,  instances  where  the  temperature  was  subnormal,  a  small  rapid 
pulse,  great  weakness,  often  complete  paralysis,  great  depression  and 
indifference  to  surroundings.  Death  generally  follows  with  every  symp- 
tom of  collapse  in  15  to  24  hours.  If  the  symptoms  are  less  acute,  there 
is  muscular  or  intestinal  cramp,  great  difficulty  in  swallowing,  disturbance 
of  sight,  dilatation  of  the  pupils,  bloody  urine.  When  an  animal  makes 
a  recovery,  it  is  very  weak  for  a  long  time,  and  it  is  almost  impossible  to 
get  the  animal  to  eat. 

After  death,  the  process  of  decomposition  begins  almost  imme- 
diately, and  if  a  post-mortem  is  to  be  held,  it  must  be  made  as  soon  as 
possible.  If  this  is  done,  the  stomach  and  intestines  will  present,  an 
intense  hemorrhagic  inflammation  of  their  walls,  swelling  of  the  follicles 
and  mesenteric  glands,  as  well  as  severe  inflammatory  changes  in  the 
adjacent  organs,  liver,  spleen,  heart,  etc. 

The  treatment  has  to  be  symptomatic.  In  the  beginning  give  an 
emetic  (apomorphia)  subcutaneously,  washing  out  the  stomach,  with 
warm  water,  or  very  weak  solution  of  creolin,  and  the  administration  of 
purgatives,  emulsions  of  castor,  olive,  or  linseed  oil,  and  tepid  rectal  injec- 
tions of  creolin,  and  massage  the  abdomen  with  alcohol  or  a  jDriessnitz 
compress,  with  tepid  water  or  flaxseed  poultice.  The  bodily  strength 
of  the  animal  should  be  kept  up,  with  black  cofTee,  wine,  whiskey,  or 
brandy,  spirits  of  camphor.  When  there  is  great  depression,  spirits  of 
camphor  may  be  injected  subcutaneously.  In  mild  cases  we  may  treat 
them  in  certain  lines  as  catarrh  of  the  stomach  and  intestines.  The 
animal  should  be  fed  on  light  foods,  easily  digested,  and  in  small  quantities, 
no  solid  meat  the  first  forty-eight  hours. 

Constipation,     Costiveness. 

This  condition  may  result,  from  the  animal  eating  food  that  is  diffi- 
cult to  digest,  i.e.,  potatoes,  bread,  beans,  peas,  dog  biscuit,  corn  flour, 
bones,  particularly  calf  bones,  or  where  the  animal  has  little  or  no  exercise, 
animal  kept  on  the  chain  or  penned  in  a  small  yard,  hunting  dogs  that 
have  worked  hard  during  the  open  season  and  during  spring  and  summer 
do  nothing,  old  dogs  that  have  weakened  digestions,  particularly  if  they 
have  suffered  from  chronic  intestinal  catarrh  (see  under  that  heading). 
Costiveness  is  also  seen  as  a  result  of  fever,  rheumatism,  peritonitis, 
catarrhal  icterus,  and  diseases  of  the  spine. 


OBSTIPATION  G5 

Obstipation. 

(Occlusio  Intestini;  Ohturatio  Intestini. 

Constrictions  of  the  intestinal  tract  may  be  formed  in  any  region  and 
may  vary  in  degree.  They  always  produce  more  or  less  obstructions  to 
the  passage  of  the  alimentary  matter,  and  when  the  constriction  becomes 
complete,  the  intestinal  contents,  being  unable  to  pass,  usually  return 
toward  the  stomach  again,  and  are  expelled  by  vomiting.  In  such  cases 
the  animals  die  quickly.  This  is  noticed  in  very  rare  instances,  where  a 
hernia  has  strangulated  and  completely  blocked  up  the  canal.  (For 
further  details  see  chapter  on  Hernia.) 

Constriction  may  be  caused  by  abnormal  conditions  of  the  intestinal 
contents,  from  the  alteration  of  the  intestinal  walls,  by  changes  in  the 
position  of  the  intestines,  and,  lastly,  from  external  pressure. 

The  bowel  is  often  blocked  up  by  masses  of  excrement,  as  a  result 
of  improper  food  or  feeding  which  is  not  digested  in  the  stomach  or 
intestine;  these  collections  reach  the  lower  bowel  and  from  the  constant 
accumulations  of  excrement  coming  down  from  the  small  intestines 
gradually  blocks  up  the  entire  tract.  We  also  see  obstructions,  caused 
by  pieces  of  wood  or  splinters  of  bone,  that  collect  masses  of  fseces  around 
them  and  fill  up  the  bowel,  forming  intestinal  stones  or  calculi  (copro- 
liths).  These  invariably  have  a  nidus  or  centre  consisting  of  a  marble, 
pieces  of  cork,  sponge,  or  other  foreign  bodies,  or  it  may  be  caused  by 
large  pieces  of  bone,  stones,  glass  or  metal  balls,  nuts,  pieces  of  leather, 
etc.,  some  of  which  may  be  swallowed  accidentally  in  the  case  of  trick 
dogs,  or  in  play. 

The  constriction  of  the  intestine,  from  being  enclosed  in  a  hernia 
and  the  impaction  of  the  intestinal  contents  pressing  into  the  part  is  fre- 
quently seen  in  the  dog.  The  intestine  frequently  becomes  twisted  or 
knotted,  or  even  invaginated.  These  complications,  as  a  rule,  occur  in 
the  small  intestines.  External  compression  of  the  intestines  is  frequently 
caused  from  enlarged  prostate  or  sarcomas  in  the  pelvic  cavity,  helminths 
or  parasites  that  lie  in  cyst  formations  in  the  mucous  membrane  of  the 
intestines.  Sometimes  enormous  abscesses  form  in  the  abdominal  cavity, 
and  in  rare  instances  they  are  caused  by  accumulations  of  fluids  in  the 
abdominal  cavity,  as  in  the  case  of  ascites.  In  newly  born  puppies  we 
sometimes  see  a  congenital  obstruction  of  the  rectum  (atresia  ani). 
-Great  masses  of  fsecal  matter  may  accumulate  in  the  anal  pouch;  this  may 
be  due  in  some  cases  to  the  swelling  of  the  anal  glands,  or  by  the  accu- 
mulation of  masses  of  hair  gluing  around  the  rectum  and  preventing 
defecation;  the  same  condition  is  seen  in  tumors  of  the  anus  or  rectum. 
For  further  details  see  page  29. 
5 


66  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

When  a  portion  of  the  intestine  becomes  obstructed,  the  following 
changes  take  place:  In  front  of  the  obstruction,  an  enlargement  forms, 
due  to  the  accumulation  of  gas  and  excrement  matter,  while  the  portion 
of  the  intestine  beyond  the  obstruction  is  empty  and  constricted.  The 
accumulation  of  gas  and  matter  causes  an  intense  inflammation  of  the 
mucous  membranes,  which  extends  to  the  muscular  coat  of  the  intestines 
and  soon  to  the  serous  coat,  and  quickly  the  entire  intestinal  tract  is 
involved  in  the  inflammation,  the  constricted  portion  becomes  mortified, 
and  perforation  follows,  allowing  the  contents  of  the  intestines  to  escape 
in  the  abdominal  cavity,  causing  purulent  peritonitis. 

Clinical  Symptoms  of  Constipation. — The  symptoms  and  course  of 
constipation  are  due  to  so  many  different  causes  that  they  will  be  de- 
scribed separately. 

In  mild  cases  of  constipation  the  symptoms  are  not  especially  charac- 
teristic and  resemble  chronic  catarrh  of  the  stomach.  At  fii'st  the  animal 
is  noticed  to  defecate  irregularly,  the  stools  are  smaller  and  passed  appar- 
ently with  more  or  less  difficulty,  which  is  especially  noticeable,  consider- 
ing the  stools  are  very  much  smaller  than  natural. 

When  from  having  little  exercise  and  living  on  highly  spiced  foods, 
(veal  or  game,)  or  eating  quantities  of  bone  that  they  are  unable  to  digest, 
great  accumulation  of  faecal  matter  gathers  in  the  colon  and  rectum.  The 
most  marked  symptom  is  the  repeated  attempts  of  the  animal  to  defecate 
without  any  results  or  after  great  efforts  only  succeeding  in  passing  a 
small  cjuantity  of  faeces.  These  are  coated  with  mucus  or  blood  and  are 
passed  with  more  or  less  pain.  The  stools  are  small  and  are  generally 
yellowish-brown  in  color,  and  in  powder-like  masses  that  break  up  easily, 
showing  no  moisture  in  them.  The  position  of  the  tail  is  characteristic. 
It  is  carried  so  as  to  form  a  curve  at  the  rectum,  the  curve  being  from 
the  base  to  one-half  of  the  tail.  On  pressing  the  fingers  into  the  sides  of 
the  abdomen,  at  the  entrance  of  the  pelvis  up  toward  the  spinal  cord, 
we  find  an  elongated  sausage-like  body  which  is  extremely  sensitive  to 
the  touch.  This  hard  mass  is  found  to  extend  downward  and  forward 
toward  the  umbilicus.  The  intestines  are  greatly  swollen  on  account  of 
the  accumulation  of  gas  and  vomiting  is  sometimes  present  (Fig.  28). 
On  making  an  examination  of  the  intestines  by  the  hand,  we  may  be 
able  to  detect  the  distention.  The  colon  is  found  to  be  dilated,  through 
its  entire  length,  forming  an  enormous  sac,  filled  with  a  putty-like  mass; 
and  during  palpation  the  animal  as  a  rule  evinces  pain  and  resists  it.  This 
examination  should  be  carefully  made,  as  it  may  lead  to  the  discovery  of 
the  original  cause  of  the  constipation.  Slight  diarrhoea  may  sometimes 
be  present  in  severe  constipation;  this  is  due  to  the  mass  lying  in  a  sac 
or  pouch  in  the  intestine,  the  firmer  material  gradually  accumulating  and 
the  fluid  faeces  passing  over  the  collected  mass.     Long  continued  consti- 


OBSTIPATION  67 

pation  (coprostasis)  may  cause  infection  of  the  blood  from  absorption, 
of  the  fsecal  matter,  enteritis,  mortification,  peritonitis  and  death. 

Symptoms  of  Obstruction  of  the  Intestines. — In  complete  occlusion 
of  the  intestines,  due  to  foreign  bodies,  invagination  or  tortion,  the 
animal  is  irritable  and  cross  and  Trasbot  has  seen  cases  where  the  animal 
showed  symptoms  very  similar  to  rabies  or  where  it  may  present  the 
other  extreme,  being  dull  and  indifferent  to  the  surroundings,  refusing 
all  food,  but  showing  great  thirst,  with  no  passage  of  faeces  whatever. 
The  rectal  temperature  is  slightly  increased,  the  lower  portion  of  the 
abdomen  is  inflated  with  gas  and  very  painful,  even  on  the  slightest 
pressure;  in  some  cases  we  may  find  decided  icterus. 


Fig.  28. — Dog  with  obstruction  of  the  intestines. 

The  vomiting  is  constant  and  very  severe,  particularly  in  the  later 
stages  of  the  disease,  the  animal  vomiting  whenever  it  drinks  any  water. 
At  first  the  vomited  matter  is  normal,  but  later  on  it  assumes  a  greenish 
color  (bile)  and  finally  putrid,  containing  pieces  of  faecal  matter. 

By  examining  the  abdominal  region  with  the  hand  we  can  generally 
locate  the  obstruction,  which  is  hard  and  exceedingly  painful  on  pressure. 
The  swelling  can  be  moved  about  showing  it  to  be  part  of  the  intestine. 

In  ordinary  cases  of  constriction  of  the  intestines,  no  definite  prog- 
nosis can  be  made  with  any  degree  of  certainty  as  to  its  course  and 
duration.  The  constriction  of  the  intestine  may  go  on  gradually  and  not 
cause  any  serious  symptoms  for  a  long  time,  or  it  may  progress  very 
rapidly  and  cause  a  complete  constriction  in  two  or  three  weeks.     Where 


C8  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

the  condition  continues  for  some  time,  the  animal  becomes  gradually 
weaker  from  day  to  day,  loses  flesh  rapidly,  pulse  is  smaller  and  finally 
imperceptible,  the  temperature  may  rise  but  frequently  it  remains  normal, 
in  a  few  days  the  animal  may  die  in  a  condition  of  collapse.  A  favorable 
termination  may  result,  and  foreign  bodies,  such  as  pieces  of  cork,  bone  or 
wood  may  be  macerated  and  passed  out  finally  without  any  great  trouble. 
It  is  not  difficult,  as  a  rule,  to  detect  the  existence  of  a  foreign  body  in  the 
intestines,  but  it  is  very  difficult  to  tell  its  exact  nature.  By  means  of 
palpation  of  the  abdomen,  see  page  25,  we  may  be  able  to  detect  hard, 
foreign  bodies,  or  objects,  such  as  hair  balls,  but  invagination  or  twisting 
of  the  intestines  is,  however,  rather  difficult  to  diagnose.  Metallic  ob- 
jects, stones,  etc.,  can  be  diagnosed  by  means  of  the  Rontgen  or  X-ray,  or 
by  performing  laparotomy.  Where  the  intestine  is  completel}^  obstructed, 
in  front  of  the  obstructed  portion  of  the  intestine,  is  greatly  distended, 
due  to  the  collection  of  faeces  and  gas,  and  the  intestine  immediately 
after  the  obstruction  is  contracted  and  empty.  At  the  obstructed  point 
there  will  be  found  great  inflammation  of  the  mucous  membrane,  which 
finally  affects  the  muscular  and  serous  coat  and  peritonitis,  or  the  portion 
becomes  necrosed  and  a  purulent  peritonitis  follows  and  the  animal  at  any 
of  these  stages  may  die  of  septicaemia. 

Therapeutics. — In  an  ordinary  case  of  constipation  give  plenty 
of  exercise  and  a  carefully  regulated  diet.  If  it  is  advisable  to  give  the 
animal  very  little  food  for  a  few  days,  give  plenty  of  water  and  small 
quantities  of  soup,  either  beef  or  vegetable.  In  old  animals,  where  diges- 
tion is  more  or  less  weakened,  give  easily  digested  food  and  no  bones 
whatever.  Clysters  or  mechanical  laxatives,  such  as  glycerine  or  soap 
suppositories,  and  massage  of  the  abdomen  is  advised.  As  a  laxative, 
oleum  ricini  15.0  to  30.0  in  a  capsule  or  emulsion,  Glauber  or  Epsom  salts, 
10.0  to  20.0,  Hunyadi  Janos,  or  Apenta  water,  teaspoonful  doses. 

When  a  case  is  very  ol^stinate  and  does  not  respond  to  the  previously 
advised  treatment,  especially  where  we  find  the  large  colon  filled  with 
fseces,  and  laxatives  have  no  effect,  the  rectum  must  be  emptied.  The 
finger  after  being  well  oiled  is  introduced  into  the  anus  where  there  will 
be  found  hard  fsecal  masses  in  front  of  the  sphincter.  It  is  generally 
impossible  to  remove  them,  except  by  breaking  them  up,  cither  with  the 
finger  or  having  first  injected  a  small  quantity  of  oil  or  glycerine  into  the 
rectum,  or  the  handle  of  a  spoon  can  be  used  to  break  up  the  masses, 
taking  care  not  to  injure  the  mucous  membrane.  This  is  to  be  followed 
by  the  injection  of  the  clysters  by  means  of  the  hose  and  funnel  (see  Fig. 
29).  The  lower  part  of  the  bowel  is  filled  with  a  coml^ination  of  luke- 
warm water  and  a  small  quantity  of  oil.  These  clysters  should  be  re- 
peated frequently,  at  least  several  times  a  day,  or  even  several  days,  until 
the  whole  canal  is  emptied.     Or  what  is  better,  glycerine  suppositories, 


OBSTIPATION 


69 


and  later  on  administer  a  sharp  purgative,  followed  by  the  administra- 
tion of  drop-doses  of  tincture  of  nux  vomica. 

The  subcutaneous  injection  of  such  drugs  as  physostigmin,  pilo- 
carpine and  arecoline  are  not,  as  a  rule,  satisfactory  and  barium  chloride, 


Fig.  29. — Mode  of  administering  a  clj'ster. 

ichthlargan,  tallianine  are  not  to  be  advised,  as  their  results  are  not  at  all 
satifactory  and  at  times  actually  dangerous  to  the  animal.  These  latter 
drugs  are  administered  by  intravenous  injection  into  the  saphena  vein. 
The  vein  is  dilated  by  means  of  pressure  and  when  filled,  the  hypodermic 
needle  is  thrust  into  it,  taking  care  the  needle  punctures  the  vein,  which 
will  be  indicated  by  a  few  drops  of  blood  coming  from  the  needle  and  con- 
tinuing to  drop  as  long  as  the  pressure  is  kept  on  the  vein.     If  it  is  the 


70 


DISEASES  OF  THE  DIGESTIVE  APPARATUS 


cellular  tissue  no  venous  blood  escapes.  The  injection  is  made  and  the 
opening  closed  with  collodion.  As  in  the  case  in  strangulated  hernia, 
or  in  the  case  of  accumulation  of  the  faeces  in  the  rectum,  due  to  faecal 
stagnation^  or  from  the  ulceration  of  abscesses  of  the  rectum,  we  will 
have  to  treat  them  as  described  above;  but  we  may  add  to  that  the  in- 
jection of  large  quantities  of  soapy  water  several  times  daily,  which  can 
be  given  with  the  apparatus  illustrated  in  Fig.  29,  and  a  dose  of  calomel 
followed  by  castor  or  olive  oil  or  glycerine  injections  into  the  rectum,  or 
suppositories  in  the  form  of  glycerine,  or  a  solution  of  glycerine  and 
water  1  to  10. 

The  stenosis  of  the  bowel  that  is  caused  by  the  impaction  of  foreign 
bodies  is  best  treated  with  laxatives  and  not  with  purgatives.  A'ogel 
and  others  advise  in  the  case  of  sharp  or  pointed  objects,  to  feed  the 


Fig.  30. — Lambert. suture. 

animal  on  thin  liquid  foods,  soups  of  peas  and  vegetables,  but  if  we  do 
not  succeed  in  getting  rid  of  the  foreign  body  and,  if  a  positive  diagnosis 
has  been  made,  it  is  best  to  perform  laparo-enterotomy  as  soon  as  pos- 
sible, and  not  wait  until  gangrene  and  peritonitis  have  set  in. 

Laparo-enterotomy  is  performed  in  the  following  manner:  the  ani- 
mal is  anaesthetized  and  placed  on  its  back,  the  lower  part  of  the  abdom- 
inal wall  shaved  and  washed  with  antiseptics.  Make  an  incision,  through 
the  linea  alba,  posterior  to  the  umbilicus,  back  to  the  margin  of  the  pubis 
about  5  to  8  cm.  long.  First  cut  through  the  skin,  then  the  muscles. 
Before  going  into  the  abdominal  cavity,  all  the  hemorrhage  must  be 
checked  and  the  blood  cleaned  off,  and  then  with  the  thumb  and  index 
jfinger  go  into  the  abdominal  cavity  and,  having  located  the  portion  of 
the  intestine  wanted,  pull  it  through  the  opening  and  hold  the  lips  of  the 
wound  together;  an  assistant  can  hold  the  edges  of  the  wound  together 
and  prevent  the  rest  of  the  intestines  from  escaping,  and  also  to  prevent 
possible  infection  from  the  escaping  fluids,  when  the  incision  is  made  in 


OBSTIPATION  71 

the  intestine.  Make  the  cut  longitudinally,  on  the  intestinal  line,  on  the 
opposite  side  from  the  mesentery,  remove  the  foreign  body,  taking  care  all 
through  the  operation  to  prevent  the  fluids  escaping  into  the  al)dominal 
cavity.  "Wash  the  inside  of  the  intestines  with  an  antiseptic  and  unite  it 
by  means  of  Lambert's  suture  (see  Fig.  30)  or  Czerny's  double  suture 
(see  Fig.  31).  For  more  exact  detail  on  this  subject,  the  reader  is  referred 
to  the  works  on  canine  surgery  by  French  or  Hobday.  The  operator  now 
takes  a  fine  curved  needle,  and  fine  cat-gut  suture  and  puts  a  number 
of  stitches  through  the  mucous  membrane  and  serous  tissues,  taking  care 
not  to  go  through  the  mucous  memljrane,  so  that  when  the  thread  is 
tightened  the  two  edges  of  the  cut  will  he  brought  so  as  to  face  into  the 
intestine;  these  are  tied,  and  another  line  of  stitches  is  made  over  the 
first,  as  is  illustrated  in  the  accompanying  Fig.  31.  The  intestine  is 
returned  to  the  cavit}',  and  the  external  wound  sewed  up  with  silk  and 


Fig.  31. — Suture  of  the  intestines     {Czerny). 

dressed  with  an  antiseptic  dressing.     In  the  male  dog  see  that  the  dress- 
ing is  not  soiled  with  urine. 

The  opening  of  the  abdominal  cavity  is  also  to  be  performed  in  eases 
"where  we  can  recognize  a  total  constriction  of  the  bowels.  In  these  cases 
where  the  anatomical  cause  of  the  disease  cannot  be  clearly  established, 
we  have  no  other  way  to  proceed  than  to  treat  the  symptoms  as  they 
present  themselves,  that  is  to  give  purgatives,  or,  in  any  case,  do  not 
neglect  to  give  plenty  of  watery  clysters.  The  general  treatment  must 
be  directed  toward  keeping  up  the  animal's  strength.  The  first  forty- 
eight  hours  only  water  must  be  given  and  in  small  quantities.  Subcu- 
taneous injections  of  the  spirits  of  camphor  or  ether  are  better  than 
administering  them  by  the  mouth,  as  they  are  vomited  immediately. 
Do  not  give  the  animal  any  food  until  the  intestinal  obstruction  has  been 
removed  or  at  least  until  there  have  been  free  defecation  and  the  pas- 
sage of  the  intestinal  gas  and  the  general  condition  is  improved.  And  on 
the  third  day  the  animal  may  be  given  food;  it  must  be  of  the  lightest 
and  easiest  digested,  such  as  soups,  milk,  bouillon  with  egg,  meat,  peptone, 
and  on  the  fourth  day  finely  scraped  rare  or  raw  beef,  or  some  of  the 


72  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

various  foods  used  as  substitutes  for  milk.  "Where  the  animal  is  subject 
to  fffcal  obstructions,  it  is  well  never  to  let  him  have  bones  if  it  can  pos- 
sibly be  avoided. 

Intestinal  invagination  occurs  as  a  result  of  irregular  or  extraordinary 
poristalsis,  particularly  when  the  intestinal  wall  is  in  a  relaxed,  debilitated 
condition,  as  a  result  of  intestinal  catarrh  from  prolonged  administration 
of  laxatives.  Death  as  a  rule  occurs  from  the  fifth  to  tenth  day.  The 
symptoms  of  invagination  are  those  of  occlusion  of  the  intestines,  see 
the  above,  and  more  or  less  blood  on  the  fa?ces.  We  may  be  able  by  pal- 
pation to  detect  the  invaginated  portion  by  feeling  a  circumscribed 
elastic,  elongated,  sausage-like  portion  along  the  intestinal  tract.  This 
is  extremely  painful  on  pressure.  If  it  is  detected,  perform  laparotomy, 
reduce  the  invagination  by  lifting  out  the  loop  of  intestine  and  reducing 
the  invagination,  but  if  the  irritation  is  too  great,  or  necrosis  has  devel- 
oped, perform  enterectomy.     See  further  on  under  Enterectomy. 

Chronic  Constipation. — This  is  seen  occasionally  in  the  dog.  It  is 
due  to  a  weakened  or  lessened  peristaltic  action  of  the  bowels.  It  is  seen 
in  all  chronic  diseases  that  are  accompanied  by  emaciation  and  debility, 
as  in  chronic  catarrh,  fevers,  icterus,  chronic  peritonitis  and  in  many  dis- 
eases of  the  nervous  system;  but  it  may  be  observed  in  many  old  but 
healthy  dogs,  caused  by  an  atrophy  of  the  mucous  and  muscular  mem- 
branes of  the  intestines.  This  disease  is  frequently  called  chronic  obsti- 
pation, for  it  causes  a  form  of  constipation  which  would,  as  can  be  readily 
understood,  cause  just  such  a  train  of  symptoms  as  has  been  described 
above. 

These  animals  should  be  fed  on  non-stimulating,  easily  digested  food 
with  or  without  the  admixture  of  vegetable  soup,  and  also  plenty  of 
exercise  and  small  doses  of  tincture  of  nux  vomica.  This  treatment  is  far 
better  than  the  frecjuent  administration  of  purgatives,  especially 
Glauber  salt,  jalap  or  aloes  and  cathartic  pills. 

Enterectomy,  Entero  anastomosis. — This  operation  becomes  necessary 
when  a  portion  of  the  intestine  becomes  necrosed  or  where  stenosis  of  a 


Fig.  32. — Hairpin  method  of  anastomosis,  showing  the  manner  in  which  the  pin  is  bent. 

certain  portion  causes  accumulation  of  fa?cal  matter  anterior  to  the 
contraction.  The  operation  is  only  possible  where  there  is  a  small  sec- 
tion of  the  intestine  to  be  removed,  as  a  section  of  any  amount  is  apt,  if 
the  animal  makes  a  recovery,  to  be  followed  very  quickly  by  marasmus 
and  terminate  fatally  in  a  very  short  time. 

French  has  devised  a  very  simple  mode  of  operation,  the  technique 
of  which  has  proved  very  efficacious  in  the  writer's  hands.     It  is  as  follows : 


OBSTIPATION 


73 


The  animal  is  put  under  ether  after  the  familiar  antiseptic  precautions 
are  used,  cut  down  on  the  abdominal  wall  and  having  exposed  the 
necrosed  or  the  stenosed  portion,  as  the  case  may  be,  and  very  carefully 
inspect  the  mesenteric  blood  supply,  as  great  care  has  to  be  taken  not  to 


Fig.  33. — Hairpin  method  of  anastomosis,  first  stage  {French). 

ligate  any  vessel  that  would  supply  any  but  the  portion  removed.  The 
vessels  are  ligated  by  means  of  a  curved  needle  being  passed  around  them 
through  the  mesentery,  the  anastomosing  loop  of  the  blood  vessel  being 
taken  up  as  close  to  the  point  of  incision  as  possible.     Then  an  ordinary 


Fig.  34. — Hairpin  method  of  anastomosis,  second  stage  {French). 

lady's  hairpin,  bent  as  in  the  accompanying  cut  (Fig.  32),  is  taken  and 
one  prong  is  passed  transversely  across  the  intestine  and  the  free  ends  of 
the  pin  are  seized  by  a  pair  of  hemostatic  forceps  or  tied  with  sutures  and 
another  pin  is  inserted  in  a  similar  manner  at  the  other  point  of  resection; 


74  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

this  point  of  the  operation  is  illustrated  in  Fig.  33.  The  intestine  is 
now  cut  close  to  the  pins,  and  the  mesentery  cut  as  shown  in  the  dotted 
line,  the  severed  ends  with  the  pins  brought  together  and  the  pins  tied 
or  held  by  forceps  both  top  and  bottom  (Fig.  34),  and  the  suture  is  com- 
menced at  the  mesentery,  putting  in  the  Lambert  stitch  on  one  side,  then 
turn  over  the  intestine  and  stitch  the  other  side.  The  stitching  is  to  be 
done  very  carefully  and  evenly,  as  on  this  depends  the  adhesion  of  the 
anastomosis.  French  recommends  the  ordinary  milliner's  instead  of  the 
surgical  needle,  as  it  makes  a  cylindrical  hole  that  has  no  ragged  edge 
and  the  opening  adapts  itself  to  the  suture,  preventing  hemorrhage  or 
leakage;  the  tops  of  the  pins  are  now  cut  off  by  means  of  a  pair  of  wire- 
cutters  and  withdrawn,  one  at  a  time,  and  the  two  openings  left  by  the 
pins  are  sutured;  great  care  is  to  be  taken  to  keep  the  margins  of  the 
mesentery  in  apposition;  the  cut  in  the  mesentery  is  now  closed  by  means 
of  a  continuous  suture.  The  after-treatment  consists  in  keeping  the 
animal  on  a  strict  liquid  diet,  juice  of  meat,  clear  soup,  or  bouillon  for 
at  least  a  week  or  ten  days. 

Prolapsus  of  the  Rectum. 

{Prolapsus  Recti  et  Ani.) 

Etiology  and  Pathological  Anatomy. — The  lower  bowel  is  kept  in 
place  by  the  peri-proctal  connective  tissue,  the  rectal  ring,  the  levator 
ani  and  the  sphincter  ani.  By  relaxing  or  distending  these  supports,  we 
find  a  prolapsus  of  the  mucous  membrane,  or  even  the  entire  rectum 
may  be  protruded  (prolapsus  recti),  or  a  certain  portion  of  the  intestine 
may  become  invaginated  and  only  the  invaginated  portion  protrude 
(prolapsus  recti  cum  invaginatione)  or  the  prolapsed  intestine  may  cause 
a  rectal  hernia  (hernia  recti  rectocele).  If  this  prolapsus  is  not  relieved 
soon,  it  inflames  very  quickly  and  becomes  torn  and  ulcerated,  forming  a 
great  swelling.  It  may  become  strangulated,  and  in  rare  cases  gangre- 
nous. It  generally  results  from  a  relaxed  condition  of  the  rectal  mucous 
membrane  or  from  excessive  straining,  from  constipation,  diarrhoea,  or 
labor  pains,  from  the  continued  use  of  hot  or  irritating  clysters,  from 
constitutional  weakness  of  the  sphincters  and  the  peri-proctal  connective 
tissues.  It  frequently  occurs  in  young  dogs  that  have  catarrh  of  the 
lower  bowel  or  as  an  accompaniment  to  distemper. 

Symptoms. — If  the  mucous  membrane  is  slightly  protruded,  it  is  only 
noticed  during  defecation  or  urination.  It  is  seen  in  the  form  of  dark 
red  wrinkles  that  protrude  from  the  rectum  as  soon  as  the  abdominal 
pressure  has  ceased.  If  the  whole  bowel  is  prolapsed,  we  find  under  the 
tail  a  cylindrical  projection,  which  protrudes  from  where  the  anus  was,  and 
hangs  downward.     The  mucous  membrane  that  is  exposed  is  wrinkled 


PROLAPSUS  OF  THE  RECTUM 


75 


and  congested,  and  at  the  centre  of  the  dependent  portion  an  indenta- 
tion is  seen;  this  is  the  opening  of  the  intestine.  Through  this  we  can 
introduce  the  finger  into  the  intestine.  At  the  anterior  end,  the  mucous 
membrane  passes  directly  into  the  skin  and  the  anal  opening.  If  there 
is  any  invagination,  the  membrane  does  not  terminate  at  the  anus,  but 
seems  to  go  into  the  rectum,  and  the  protrusion  can  be  lifted  up  and 
passed  into  the  rectum  between  the  swelling  and  the  rectum  (see  Fig.  35). 
Therapeutics. — The  first  thing  to  do  is  to  remove  the  cause,  whether 
it   be   due   to   diarrhoea   or  constipation,  by  putting  the  animal  under 


Fig.  35. — Prolapsus  of  the  rectum  with  invagination. 

treatment  suitable  for  such  conditions.  The  most  important  thing  to  do 
is  to  reduce  the  prolapsus  as  soon  as  possible;  place  the  dog  on  his  front 
legs  and  elevate  the  hind  ones,  and  having  cleaned  and  oiled  the  inflamed 
portion,  return  it  to  its  normal  position  and  fill  it  with  astringent  solu- 
tion, and  if  it  is  a  long-standing  case,  opium  in  suppository  or  5  per 
cent,  solution  cocaine.  If  the  mucous  membrane  is  very  much  swollen 
and  inflamed,  it  is  best  to  scarify  it  slightly.  If  the  folds  of  the  mucous 
membrane  are  blackened  and  necrosed  from  prolonged  exposure,  they 
must  be  trimmed  off  with  the  scissors.  The  writer  has  generally  suc- 
ceeded, even  in  very  bad  cases,  in  reducing  the  protrusions  by  bathing 


7G  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

them  with  cokl  water  or  l)y  compressing  the  protruded  intestine  on  a 
rubber  band,  or  muslin,  commencing  at  the  external  end  and  winding 
toward  the  base  of  the  swelling  and  while  it  is  reduced  by  the  pressure 
return  it  to  its  normal  position.  It  is  much  more  difficult  to  reduce  an 
invaginated  intestine,  as  the  more  you  press  on  the  protruded  portion 
the  more  it  packs  into  the  end  of  the  rectum.  A  large  bougie  or  candle 
is  inserted  in  the  end  of  the  protruded  portion,  and  then  it  is  pressed  into 
its  natural  position;  or  if  this  does  not  succeed,  perform  laparotomy  and 
draw  the  invaginated  intestine  back  into  position  from  the  abdominal 
cavity.  There  is  little  danger  from  this  operation,  if  it  is  performed 
with  ordinary  caution.  The  administration  of  a  hypodermic  injection 
of  morphia  will  insure  relaxation  and  less  straining  on  the  part  of  the 
animal. 

After  replacing  the  intestine,  it  is  generally  necessary  to  place  a  stitch 
around  the  perineum,  so  as  to  prevent  the  recurrence  of  the  protrusion. 
What  is  called  a  tobacco  pouch  stitch  is  carried  around  the  anus,  and  when 
the  strings  are  drawn  it  will  be  seen  (as  in  the  cut,  Fig.  36)  that  it  prevents 
a  recurrence  of  the  protrusion  by  drawing  the  anus  together.  The  sewing 
of  the  rectum  by  this  stitch  closes  up  the  opening  sufficiently  to  prevent 
the  bowel  coming  out,  but  n,ot  enough  to  prevent  the  escape  of  liquid 
faecal  matter.  It  is  not  advisable  to  apply  cold  irrigations  or  inject 
astringents,  as  the  dog  is  very  apt  to  strain  more  violently  after  applica- 
tion of  either  of  these  remedies. 

At  the  same  time,  if  the  trouble  is  caused  by  diarrhoea,  give  opium, 
and  if  caused  by  constipation,  administer  saline  purgatives.  Stockfelt 
advised  that  a  series  of  pins  should  be  placed  around  the  rectum 
and  united  with  threads,  and  thus  produce  a  greater  constriction 
from  the  cicatrix  when  the  irritation  heals,  so  as  to  hold  the  parts  in 
position. 

Grey  made  an  opening  on  the  median  line  of  the  abdomen  and  drew 
back  the  intestine  and  stitched  it  to  the  opening  with  cat-gut  sutures, 
taking  care  not  to  put  the  stitch  through  into  the  mucous  membrane  of 
the  intestine. 

When  the  prolapsus  has  been  of  long  duration  and  reduction  seems 
impossible,  it  is  best  to  take  means  to  remove  the  protruded  portion  of 
the  intestines. 

Amputation  and  Sewing  by  Means  of  the  Double  Suture. — Cut  off 
the  hair  from  the  region  of  the  anus,  then  wash  the  affected  parts  and 
region,  with  an  antiseptic,  put  the  animal  under  ether,  the  animal  is  laid 
on  a  table,  the  posterior  part  of  the  body  is  elevated,  the  prolapsed  por- 
tion pulled  out  by  means  of  forceps  until  normal  mucous  membrane  is 
seen.  Then  wash  off  and  apply  a  rubber  band  tourniquet  as  close  up  to 
the  anus  as  possible,  then  a  curved  needle  is  passed  through  both  layers, 


PROLAPSUS  OF  THE  RECTUM 


and  brought  up  to  the  surface.  This  is  facilitated  by  inserting  an  ordi- 
nary thermometer  into  the  lumen  of  the  intestine  (Hobday)  or,  better  still, 
a  cylinder  of  carrot  (^"iborg).  Tie  this  stitch  and  put  another  stitch  be- 
side this,  and  continue  around  the  intestine  until 
it  is  stitched  up.  Cut  off  the  portion  posterior  to 
the  stitches,  remove  portion  of  carrot  and  push  the 
stump  back  through  the  anus. 

Amputation  by  Means  of  a  Cross  Suture. — • 
The  method  advocated  by  Miller  is  performed  in 
the  following  manner:  the  animal  is  etherized  and 
the  hair  removed,  the  skin  cleaned  and  two  needles 
with  linen  or  silk  suture  put  crosswise,  as  in  Fig. 
37,  through  the  prolapsed  portion,  the  portion  pos- 
terior to  the  stitch,  is  cut  off;  the  stitches  are  then 
pulled  out  from  the  lumen  of  the  intestine  and  cut  in 
the  centre,  thus  making  two  threads.  These  should 
be  tied,  as  in  the  second  figure  of  the  cut. 

Another  method  is  to  place  the  animal  under 
ether,  and  having  laid  it  on  a  table  with  the  poste- 
rior extremities  elevated,  the  prolapsed  portion  is 
pulled  as  far  as  possible  out  of  the  rectum.  It 
must  then  be  rubbed  in  the  hands,  to  remove  as 

much  blood  from  it  as  possible,  or  a  rubber  band  wound  around  it,  from 
its  extremity  to  its  base,  and  finally  ligated  at  its  base,  and  then,  by 
means  of  a  bistoury,  the  protrusion  is  cut  off  about  one-half  of  an  inch 
from  the  ligation. 


Fig.  36. — Stitching  rec- 
tum (tobacco-bag  stitch); 
o,  method  of  stitching;  b, 
stitch    tied. 


Fig.  37. — Method  of  suturing  in  amputation  of  the  lower  bowel. 


After  the  blood  vessels  have  been  taken  up  by  means  of  an  in- 
terrupted stitch  (the  interrupted  stitch  is  much  better,  as  it  makes  the 
union  of  the  lips  of  the  wound  much  closer),  sew  up  the  serous  mem- 
brane, and  afterward  sew  the  muscular  and  mucous  membranes;  the 
rubber  band  is  removed,  and  the  stump  is  pushed  back  into  the  opening. 


78  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

Malformations  of  the  Rectum  and  Anus. 

Numerous  malformations  occur  in  the  rectum;  projecting  polypus 
formations  of  the  mucous  membrane  of  the  lower  bowel  may  project  from 
the  rectum  constantly,  or  may  only  be  seen  during  defecation.  We  may 
also  find  fibroma,  adenoma,  and  other  forms  of  tumors.  The  writer  had  a 
particularly  interesting  case  in  a  small  dog  that  was  cjuite  old.  The  owner 
had  observed  a  slight  bleeding  from  the  rectum  for  at  least  a  year;  the 
rectum  was  examined  by  means  of  a  speculum  and  a  carcinoma  was  found. 
It  was  located  about  5  cm.  from  anus  on  the  superior  portion  of  the  rectum. 
This  tumor  had  hard  raised  irregular  edges  and  depressed  in  the  middle. 
In  the  peri-proctal  connective  tissue,  we  occasionally  find  adenoma, 
sarcoma  and  carcinoma.  These  growths  are  apt  to  cause  considerable 
trouble,  as  they  cause  constriction  of  the  mucous  membrane  and  inter- 
fere with  defecation. 

In  the  anus,  we  find  several  types  of  tumors  which  we  class,  m  a 
general  way,  as  anal  cancers.  They  may  either  be  adenomas  or  car- 
cinomas and,  as  a  rule,  present  mushroom  or  fungus-like  bodies  growing 
firmly  in  the  skin  tissue  itself,  but  having  no  attachment  to  the  connective 
tissue.  Generally  they  are  firm,  or  slightly  elastic, and  when  they  reach 
a  certain  size,  they  are  very  slightly  attached  at  their  outer  edge,  and 
the  majority  of  them  can  be  lifted  from  their  base. 

When  they  reach  any  size,  they  are  apt  to  interfere  with  defecation. 
These  tumors  are  easily  removed,  particidarly  when  they  have  reached 
a  certain  size.  The  only  precaution  to  be  observed  is  to  remove  the 
tumor  in  its  entirety  and  to  avoid  injuring  the  sphincter,  which  would 
be  apt  to  result  either  in  paralysis  of  the  sphincter  or  a  rectal  fistula. 
Frick  advises  early  removal  of  tumors  from  the  interior  of  the  rectum. 
For  information  of  the  diseases  of  the  rectum  see  page  74. 

Imperforate  Anus,  Inflammation  of  the  Anal  Pouches,  Diverticulum  of  the 
Rectum  and  Hemorrhoids  are  classed  under  this  Heading. 

Imperforate  Anus  (Atresia  Ani  and  Atresia  Ani  et  Reeti). — This  is  a 
congenital  deformity  and  consists  of  a  defective  formation  of  the  rectum 
and  in  some  cases  of  the  lower  bowel.  It  is  seen  in  newly  born  puppies, 
and  it  is  usually  confined  to  the  cutaneous  covering  growing  over  the 
anus  (atresia  ani),  or  it  may  be  the  rectum  is  only  partially  developed 
and  it  ends  in  a  blind  sac  some  distance  from  the  rectum  (atresia  ani  et 
recti).  In  these  cases,  the  faeces  are  not  passed  and  an  artificial  opening 
must  be  made.  The  treatment  is  to  cut  the  skin  with  a  small  knife,  and 
the  edge  of  the  wound  sewed  back,  so  as  to  prevent  it  from  uniting  again; 


IMPERFORATE  ANUS 


79 


but  if  it  is  found  that  the  lower  bowel  is  entirely  occluded,  it  is  better 
to  destroy  the  puppy.  But  if  treatment  is  to  l)e  tried  as  in  a  particularly 
valuable  puppy,  we  can  make  a  cross  incision  and  by  means  of  the  index 
finger  we  locate  the  l^lind  end  of  the  floating  colon  then,  l)y  means  of  the 
forceps,  draw  it  to  the  surface,  open  it  and  stitch  the  edges  around  the 
anal  opening,  as  in  an  ordinary  wound. 

Infiammation  of  the  Anal  Pouches. — These  glands  are  located  on  both 
sides  of   the  anus,  lying   between  the  anus  and  the  mucous  membrane. 


Fig.  38. — Inflammation  of  the  anal  glands. 

The  interior  of  the  pouch  is  filled  with  tubular  shaped  glandular  tissue, 
ending  in  a  short  thin  canal,  see  Fig.  38.  The  secretion  of  the  gland  is  a 
yellowish  brown  fluid,  with  a  very  unpleasant  odor  and  an  acid  reaction. 
From  a  variety  of  causes,  such  as  local  irritation,  the  accumulation  of 
hard  faeces,  splinters  of  bone,  etc.,  and  from  various  irritations  of  the 
rectum,  these  glands  become  inflamed  and  the  anus  becomes  swollen,  on 
one  or  both  sides,  generally  the  latter.  The  region  is  warm,  painful  to  the 
touch,  and  there  is  more  or  less  fluctuation  in  the  swellings.  The  animal 
makes  repeated  attempts  at  defecation  and  there  is  every  evidence  of  ten- 
esmus. The  animal  is  continually  licking  the  anus  and  pulling  and  slid- 
ing the  hind  ciuarters  on  the  ground.  On  pressing  the  swellings  between 
the  fingers,  the  contents  of  the  anal  pouches  are  emptied  and  are  expelled 


80 


DISEASES  OF  THE  DIGESTIVE  APPARATUS 


from  the  anus;  this  is  a  thick  yellowish-brown  liquid,  often  stained  with 
blood,  and  it  has  a  very  fcetid  odor.  In  some  instances  the  swelling 
breaks  through  the  skin  at  the  anus,  forming  an  anal  fistula. 

The  treatment  consists  in  pressing  the  engorged  glandular  tissue  be- 
tween the  fingers,  either  the  two  fingers  externally,  or  putting  the  index 
finger  into  the  rectum,  and  pressing  on  the  pouches.  If  they  cannot  be 
emptied  in  this  manner,  they  must  l)e  opened  by  means  of  a  curved  bis- 
toury, and  Gutman  injects  tincture  of  iodine  into  the  gland.     In  rare 


Fig.   39. — Pseudo-perineal  hernia. 

instances  it  is  necessary  to  curette  the  pouches.  The  general  condition 
may  be  assisted  by  laxatives,  to  assist  in  easier  defecation. 

Abscess  of  the  Anal  Glands. — The  anal  glands  (acinos  gland)  which  are 
situated  in  the  sphincter,  forming  the  anus,  become  inflamed  and  cause 
a  swelling  of  the  entire  neighborhood  of  the  anus,  causing  great  inter- 
ference with  defecation.  These  generally  form  pus,  fluctuate  and  break. 
The  treatment  consists  in  opening  the  abscesses  and  treating  them 
antiseptically. 

Diverticulum  of  the  Rectum,  Pseudo-perineal  Hernia. — From  the  fre- 
quent accumulation  of  fa^'/cs  in  the  rectum,  particularly  in  old  animals, 
the  terminal  portion  of  the  floating  colon  and  rectum  becomes  dilated  and 
forms  a  sac,  and  when  this  diverticulum  becomes  filled,  the  neighboring 
structures  are  pushed  out,  and  the  condition  may  be  mistaken  for  perineal 
hernia  (Fig.  39.)     It  can  be  differentiated  from  hernia  by  the  fact  that 


HEMORRHOIDS  81 

in  this  case  the  tumor  is  hard  and  puttj^-like  and  introducing  the  finger 
into  the  rectum  it  is  found  to  be  filled  with  hard  faecal  matter.  The 
treatment  consists  in  breaking  up  the  faecal  matter  and  removing  it  either 
with  the  finger,  instruments,  or  by  means  of  clysters,  gluten  or  glycerine 
suppositories,  giving  the  animal  food  suitable  for  this  condition.  Lienaux 
operated  by  cutting  the  rectum,  pulling  out  all  the  dilated  portion, 
excising  it,  and  sewing  the  intestine  to  the  anus  as  in  prolapsus  of  the 
rectum,  (see  Fig,  37). 

Hemorrhoids. 

These  are  diffuse  or  knot-shaped  (varicose)  distentions  of  the  pos- 
terior veins  of  the  lower  bowel  at  the  anus.  According  to  their  position, 
we  may  call  them  external  or  internal  hemorrhoids. 

The  former  are  located  outside  the  sphincter  ani  and  in  the  sub- 
cutaneous connective  tissue.  The  latter  are  located  inside  the  sphincter 
and  under  the  mucous  membrane.  Sometimes  these  enlarged  veins  burst 
and  cause  considerable  hemorrhage.  This,  however,  rarely  amounts  to 
anything,  as  the  mucous  membrane  is  generally  more  or  less  inflamed  all 
the  time,  and  often  the  faeces  are  covered  with  mucous  when  they  are 
passed.     It  is  not  a  rare  affection  in  older  dogs. 

Clinical  Symptoms. — The  act  of  defecation  is  painful,  the  faeces  covered 
with  mucus  and  sometimes  blood — either  pure  blood  or  blood  and 
mucus  mixed.  On  making  a  digital  examination,  which  is  very  painful, 
the  mucous  membrane  is  found  to  be  roughened  and  uneven,  or  we  may 
see  one  knotty  lump  in  the  orifice  of  the  anus.  In  rare  instances  they 
appear  as  bluish-red  ulcers  which  encircle  the  reddened  rectum.  The 
animal  is  nervous,  irritable,  sliding  the  posterior  part  of  the  body  on  the 
floor,  especially  on  the  carpet,  so  as  to  rub  the  rectum,  and  licking  the 
anus  frequently. 

The  causes  can  generally  be  ascribed  to  a  stagnation  of  the  veins,  from 
irritation  of  the  membranes,  from  bile  or  irritants  dvie  to  poor  or  faulty 
digestion,  too  much  food,  and  in  the  majority  of  instances  it  will  be  found 
that  the  liver  is  congested  or  inactive,  from  chronic  constipation  or  lack  of 
exercise  (Vogel  states  it  follows  pregnancy),  and  carcinoma  or  stenosis 
in  the  posterior  portion  of  the  intestinal  canal.  In  some  cases  it  is  due  to 
a  disturbance  of  the  circulation,  from  disease  of  the  heart  or  lungs,  and 
from  the  irritation  of  habitual  constipation. 

Therapeutics. — The  best  treatment  to  pursue  is  first  to  use  saline  laxa- 
tives, but  not  in  large  enough  doses  to  purge,  such  as  sulphate  of  mag- 
nesia or  sulphate  of  sodium,  and  cold  enema  and  the  application  of  an 
ointment  of  lead  plaster.  Any  knots  may  be  removed  by  ligature,  scarifi- 
cation, or  by  the  scissors,  and  afterward  touched  by  the  thermocautery. 
6 


82 


DISEASES  OF  THE  DIGESTIVE  APPARATUS 


INTESTINAL  PARASITES. 

(Hehninthiasis.) 

Round  Worms,  Maw  Worms  (Ascaris  Mystax). 

Natural  History. — The  round  worm  of  the  dog,  ascaris  mystax, 
ascaris  marginata,  is  Avhite  or  yellowish-white,  slightly  reddish  in  color 
and  twisted  in  spirals;  there  is  a  difference  in  the  two  sexes  (see  Fig. 
40),  the  males  are  about  6  cm.  and  the  female  about  12  cm.  Their 
thickness  varies  from  1  to  1.5  mm.  The  head  is  slightly  flattened  and 
fitted  with  two  wing-shaped  borders,  which  start  from  the  mouth  and 
enlarge  slightly  as  they  pass  posteriorly.  The  mouth  is  a  round  small 
opening,  and  fitted  with  three  to  six  small  lips,  which  cover  a  number  of 
proportionately  large  teeth.     The  caudal  end  of  the  male  parasite  is 

n  o 


Fig.  40. — Ascaris  mystax. 

curved  and  pointed  and  has  numerous  small  papillae  on  each  side.  The 
caudal  end  of  the  female  is  pointed  and  straight.  The  vulva  is  about  the 
end  of  the  first  fourth  of  the  body  from  the  head.  In  the  genital  organs 
there  can  generally  be  seen  quantities  of  round  eggs  that  on  examination 
are  found  to  have  a  thick,  hard  shell,  which  is  marked  by  numerous 
small  grooves.  These  eggs  are  found  in  enormous  quantities  in  the 
fa*ces  of  all  dogs  affected  with  the  round  worm  (see  Fig.  15).  The  de- 
velopment of  the  embryo  is  not  yet  thoroughly  understood,  but  from  the 
experiments  of  Grassi,  Penberthy,  Albrecht,  Frohncr,  it  has  been  dem- 
onstrated that  the  intestines  of  puppies  that  have  never  taken  any- 
thing but  the  mother's  milk,  contain  numerous  ascarides,  and  they  have 
demonstrated  that  an  intermediate  host  is  not  necessary,  but  the  worms  can 
be  developed  directly  from  the  eggs  in  another  animal  of  the  same  species. 
As  a  rule,  the  round  worms  cause  little  trouble  in  the  dog.  Pem- 
bcrthy  found  250  in  a  six  weeks  old  puppy  that  had  constant  vomiting, 


T.£NIA  83 

intestinal  catarrh,  emaciation,  anaemia  and  decreased  temperature. 
But  in  some  instances,  large  masses  of  these  worms  collect  and  cause 
considerable  catarrhal  disturbance  of  the  intestines,  or  they  may  even 
cause  symptoms  of  intestinal  stenosis.  In  rare  instances,  the  parasites 
produce  numerous  hemorrhagic  furrows  or  indentations  in  the  mucous 
membrane.  There  is  no  doubt  that  in  some  cases  round  worms  cause 
considerable  nervous  disturbance,  such  as  cramps  or  epilepsy,  and  may 
even  perforate  the  intestinal  wall,  causing  a  secondary  peritonitis.  The 
penetration  of  the  parasite  into  the  bile  duct  has  been  observed  in  young 
animals — puppies  under  six  months.  From  the  observations  of  Kitt, 
Gasteiger,  Mingazzini,  there  is  no  doubt  that  these  parasites  cause  harm, 
not  only  by  absorbing  nourishment  that  should  go  to  the  host,  but  by 
producing  and  excreting  certain  toxic  substances  that  cause  both  inflam- 
matory changes  and  nervous  disturbances.  These  nervous  symptoms 
generally  disappear  with  the  expulsion  of  the  parasite. 

Therapeutics. — The  principal  agent  used  to  remove  the  round  worm 
is  floris  cinae  and  santonin,  the  alkaloid  of  the  plant  Artemisia  santon- 
ica.  Both  can  be  administered  and  followed  up  by  a  dose  of  castor 
oil,  or  the  oil  may  be  given  with  them.  The  floris  cinse  is  given  in  doses 
of  2.0  to  10.0  and  the  santonin  in  doses  of  0.05  to  0.2  for  the  adult  dog 
and  from  0.01  to  0.05  for  young  or  smaller  dogs.  For  the  young 
puppy  give  0.025  rubbed  up  in  a  little  sugar,  or  in  triturate.  Decoctions 
of  garlic,  thymol,  areca  nut,  are  all  administered  by  their  various  ad- 
vocates. As  a  prophylactic  measure,  pregnant  bitches  that  are  about 
to  whelp  and  are  suspected  of  having  ascarides  should  be  put  in  another 
place,  situated  some  distance  from  where  they  are  to  whelp  and  subse- 
quently nurse  their  puppies  and  are  then  given  medicine  to  expel  the 
parasites.  This  should  be  followed  by  a  laxative,  to  wash  out  the  para- 
sites and  what  eggs  may  be  in  the  rectum;  and  after  that  the  region  of 
the  anus  should  be  washed  to  further  remove  the  eggs  that  may  be  in  that 
region.     Then  the  bitch  is  returned  to  the  place  where  she  is  to  whelp. 

I^.     Flor.  cinje  pulv, 
01.  ricini, 
Sig. — To  be  given  on  an  empty  stomach. 
I^.     Santonin, 

Chloroformum, 
01.  ricini, 
Sacchanim, 
Sig. — One-half  in  the  morning  and  other  in  the  after- 
noon. 

I^.     Santonin,  0.2  to     0.3 

Oh  ricini,  45.0  to  60.0 

Shake  the  bottle  before  using. 

Sig  — Divide  into  three  portions  and  give  one  every 
four  hours. 


10 

.0 

50. 

0 

0. 

3 

5. 

0 

50. 

0 

0 

.01 

84  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

Tape-worm. 

Natural  History. — The  cestodes  are  flat  tape-like  worms  without 
mouth  or  intestines.  They  grow  from  one  parent  or  head  scolex  and 
adhere  together,  in  a  long  ribbon-like  colony.  The  head  is  furnished  with 
sucking  cups  and  hooks,  by  which  means  it  adheres  to  the  mucous  mem- 
branes of  the  intestines.  The  parasite  is  narrow  at  the  neck,  gradually 
widening  and  at  its  termination  it  consists  of  a  number  of  matured  seg- 
ments that  separate  from  the  parent  parasite,  when  they  are  fully  de- 
veloped, and  are  carried  out  among  the  faeces.  Each  segment  is  complete 
in  itself,  having  both  male  and  female  genital  organs.  This  order  are 
hermaphrodites  and  are  peculiar  from  the  fact  that  they  produce  the 
germs  of  the  new  nursing  mothers,  of  the  shape  of  eggs,  while  the  nurse 
remains  sexless.  The  ripe  segments  (proglottides)  are  soon  detached  and 
pass  either  into  manure,  or  in  water,  plants  or  grass.  The  proglottides 
break  up  and  the  eggs  scatter  in  all  directions.  The  eggs  are  covered 
with  a  hard,  tough  shell,  inside  of  which  is  a  six-hooked  embryo.  If  the 
egg  is  taken  into  the  stomach,  the  acid  gastric  juice  dissolves  the  shell; 
the  embryo  is  liberated,  and  immediately  fastens  the  hooks  into  the  mucous 
membrane  of  the  intestine  and  from  there  penetrates  into  the  connective 
tissue  of  some  of  the  adjacent  organs,  where  it  forms  a  sac-like  cyst. 
These  cysts  contain  fluid,  and  are  termed  bladder  worms,  when  empty 
and  cysticercus  or  cysticercoids  when  they  contain  fluid.  In  each  of  these 
bladders  we  find  the  individual  taenia  head  furnished  with  hooks  and  the 
sucking  caps.  In  some  forms  of  the  taenia  these  bladders  divide  and  sul)- 
divide  into  numerous  daughter-cysts  or  breeding  buds,  all  of  which  pro- 
duce the  little  heads  of  the  taenia.  This  is  frequently  seen  in  the  echino- 
coccus,  where  enormous  masses  are  found.  If  any  animal,  or  proper 
secondary  host,  gets  one  of  these  ripe  bladder  worms  into  the  stomach  the 
gastric  juice  dissolves  its  covering  and  it  finds  its  way  to  the  duodenum, 
where  it  fastens  itself  by  means  of  its  hooks  and  sucking  apparatus  and 
instantly  becomes  a  breeding  parasite. 

The  anatomical  structure  of  the  cestodes  is  very  simple.  The  body 
parenchyma  is  divided  into  two  layers,  an  external  and  an  inner  covering. 
In  the  latter,  we  find  the  sexual  organs.  The  external  layer  is  chiefly 
muscular,  and  contains  also  a  mass  of  calcareous  nodules  that  replace 
the  defective  bony  structure  of  the  cestodes.  The  surface  of  the  head 
is  covered  with  a  skin  or  cuticle,  from  which  the  hooks  originate.  A 
digestive  system  and  blood  vessels  are  absent,  but  in  the  inner  layer  we 
find  a  system  of  very  much  branched  water  vascular  sj^stem,  which  is 
connected  with  two  elongated  canals,  united  at  each  joint  by  a  cross 
system  of  similar  canals,  which  is  said  to  serve  as  an  excretory  apparatus. 


T^NIA 


85 


The  branches  running  into  these  canals  end  in  a  common  orifice.  Each 
link  or  segment  has  an  independent  male  and  female  sexual  appa- 
ratus. The  male  apparatus  consists  of  numerous  pear- 
shaped  testicular  bladders  with  a  canal  of  exit.  The 
end  can  be  turned  up  into  the  female  opening.  In  the 
female  portion  we  find  ovaries,  uterus  and  vagina.  The 
uterus  is  remarkably  well  defined  in  each  segment  (see 
Fig.  41). 

The  following  varieties   are  seen  in  the   dog: 
Taenia  Serrata  (Fig.  42). — This  variety  is  from  0.5 
to  6  m.  in  length  and  about  0.6  cm.  in  width  when  fully 
developed.     The  head  is  large,   proportionately,  bullet- 
shaped,   often   four-sided,   and   is  fitted   with  about  40 
hooks  in  two  rows  and  also  sucking  disks,  wdiich  are  oval    of  the  Tania  coen- 
in  shape.     The  first  sections  after  the  head  are  very  nar-    ^^^^  Cenarge 
row,  and  the  middle  sections  are  almost  four-sided.      The  anterior  bor- 


Fig 


Uterus 


Fig.  42. — Tienia  Serrata. 

der  of  the  segments  is  much  narrower  than  the  posterior.     The  edges 
are  serrated  or  saw-like,  hence  the  name.     The  genital  orifice  is  situated 


86 


DISEASES  OF  THE  DIGESTIVE  APPARATUS 


on  the  border,  alternatino;  one  on  the  right  and  next  on  the  left.  The 
full-grown  segments  are  nearly  square  or  may  be  broader  than  long. 
The  uterus  has  a  long  central  body,  with  eight  branches  on  the  side. 
These  send  out  numerous    subdivisions    from  each  individual  branch. 


Fig.  43. — Tiunia  marginata,  posterior  end  of  worm. 

The  eggs  are  indented  on  the  sides  and  have  a  hard  tough  shell,  30  to 
40  mm.  long  31  to  30  mm.  wide.  The  bladder  worm  is  found  in  the 
liver  of  the  wild  and  domestic  hare,  called  the  cysticerus  pisiformis. 
This  grape-shaped  cyst  has  been  found  to  grow  as  large  as  a  hazel  nut,  has 


T.€NIA 


87 


been  found  by  Lesbre  in  the  brain  of  a  dog  affected  by  taenia  serrata. 
This  was  probably  caused  by  self-infection.  This  animal  exhibited 
symptoms  resembling  rabies,  and  was  incessantly  grinding  the  teeth  and 
snapping  the  jaws. 

Taenia  Marginata  (Fig.  43). — This  is  the  longest  and  widest  tsnia 
of  the  dog,  being  from  1.5  to  3  m.  in  length.  In  rare  instances  it 
has  been  found  to  be  5  m.  and  the  width  of  the  developed  segments  is 
about  0.5  cm.  Its  head  is  nearly  rounded  with  four  small  sucking  disks 
and  a  double  crown  of  36  hooks.  The  segments  are  nearly  square.  In 
the  middle  of  the  colony  they  may  even  be  broader  than  long,  with  ir- 
regular edges  and  partially  overlap  the  following  section.  The  sexual 
orifice  which  is  situated  on  the  margin  may  be  alternately  on  the  right 


Fig.  44. — Taenia  cucumerina,  Dipylidium  caninum. 

or  left  side,  the  right  sections  are  longer  than  their  width,  which  are  14  to 
1(3  mm.  and  5  to  7  mm.  wide.  The  uterus  has  a  short  central  body  and 
has  five  branches  on  either  side,  which  are  intertwined.  The  eggs  are 
irregularly  round  and  enveloped  in  a  tough  thick  shell.  The  bladder 
worm  of  the  taenia  marginata  is  the  cysticercus  tenuicoUis,  and  is  found 
in  the  serous  tissues  of  the  sheep,  cow,  goat,  pig,  squirrel,  and  monkey 
in  captivity,  and  occasionally  in  man  (Dewitz).  Frequently  we  find 
the  cysticercus  on  the  peritoneum  and  liver  of  the  sheep  and  pig,  vary- 
ing in  size  from  a  pea  to  the  size  of  a  man's  fist. 

Taenia  Cucumerina  (Dipylidium  Caninum)  (Fig.  44). — This  is  a 
small  taenia  10  to  40  cm.  long  and  3  mm.  wide.  It  has  a  small  elongated 
head,  with  sixty  hooks  with  a  retracted  mouth  or  proboscis;  the  seg- 


88  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

merits  are  rounded  at  the  corners  and  are  the  shape  of  a  cucumber,  hence 
the  name,  and  have  a  small  sexual  orifice  at  each  end.  The  individual 
sections  are  about  8  to  10  mm.  long  and  3  mm.  wide.  These  segments  are 
easily  detachable,  and  are  reddish-pink  in  color.     This  coloration  is  due 


Fig.  45. — Tirnia  coenurus. 


to  the  color  of  the  shell  of  the  egg.  The  uterus  is  irregular,  with  double- 
shelled,  rounded  eggs,  six  to  fifteen  massed  together  in  elongated  cocoons. 
The  primary  stage  of  this  taenia  which  is  very  common  in  the  dog,  is  in 
the  abdominal  cavity  of  the  dog-louse  (trichodectes  canis)  (Metchnikoff) 


TAENIA 


89 


and  also  in  the  common  dog-flea  (ccrtopsyllus  canis)  and  in  the  flea  of 
man  (pulcx  iiTitans). 

Taenia  Coenurus  (Fig,  45). — This  taenia  is  generally  about  40  cm. 
long,  although  in  rare  instances  it  may  be  1  m.  It  has  a  small  pear- 
shaped  head,  with  twenty-four  to  thirty  hooks  and  four  sucking  disks. 
The  anterior  links  of  the  colony  are  always  very  short,  and  those  at 
the  extreme  end  are  elongated  and  narrow,  7  to  13  mm.  long  and  3  to 
3.5  wide,  white  and  shaped  like  a  cucumber  seed.  The  uterus  has  a  long 
central  body,  wath  eighteen  to  twenty-six  side  branches.  The  eggs 
have  a  hard  shell,  elliptical  and  30  to  30  mm.  diameter  with  an  indurated 
border.  The  larval  state  of  this  taenia,  which  is  the  coenurus  cerebralis 
(bladder  worm) ,  varies  in  size  from  a  small  seed  to  a 
large  egg,  and  has  a  numl^er  of  nursing  or  daughter- 
cysts  or  bladders  on  its  inner  wall.  It  is  generally 
located  in  the  brain,  and  in  rare  instances  in  the  spinal 
cord.     It  is  seen  in  all  ruminants,  especially  sheep. 

Taenia  Echinococcus  (Fig.  46) . — This  is  the  smallest 
taenia  of  the  dog,  most  dangerous  to  man.  Its  greatest 
length  is  4.4  mm.,  and  it  has  three  and  in  rare  instances 
four  segments.  The  last  segment  is  the  largest  and  the 
only  one  to  possess  sexual  organs.  The  uterus  is  large 
and  irregular,  without  any  central  border.  The  head  is 
round  and  has  four  sucking  bodies  and  twenty-four  to 
forty-eight  small  imperfectly  developed  hooks,  arranged 
in  two  rows.  The  eggs  are  round  and  slightly  elongated, 
the  shell  being  formed  in  several  layers.  The  bladder 
worm  is  the  echinococcus  polymorphus:  the  bladder  is  echmococcus:  a,  tape- 

.  worm,  enlarged  twelve 

filled  With  a  nonalbuminous    fluid    and   generally  has  times;  h,  cyst  con  tain- 
daughter-cysts  on  the  sides.     These  cysts  may  assume  '^^  ^^°-'^''  '^'  ^mature 

.  ...  head. 

enormous  proportions,  ranging  m  size  from  a  pea  to  a 
man's  head  or  even  larger  and  on  the  walls  we  find  numerous  ammen 
heads.     There  are  two  varieties  of  the  echinococcus,  the  distinguish- 
ing characters  being  the  length  of  the  hooks  and  the  arrangement  of 
the  eggs.     It  is  found    in   the   pig,  cattle   and   sheep  and  very  rarely 
in  solipeds  and  carnivora.      In  man  it  is  generally  found  in  or  attached 
to    the  liver  or  peritoneum,  but  it  has  also  been  found  in  the  lungs, 
kidneys,  spleen,  muscular  system,  pleura,  bones  and  the  brain. 
The  following  parasites  are  occasionally  found  in  the  dog: 
Taenia  Serialis. — This  parasite,  about  35  to  75  mm.  long,  resembles 
the  Tsnia  coenurus.     The  intermediate  host  of  this  parasite  is  found  in 
the  ral)l)it. 

Taenia Litterata,  pscudo-cucumerina ,  Taenia lineata.    This  parasite  re- 
sembles the  Taenia  cucumerina,  is  found  in  the  fox,  but  rarely  in  the  dog. 


Taenia 


90  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

When  animals  live  on  the  sea-shore  we  frequently  find  them  affected 
with  bothriocephalus  latus.  This  parasite  is  found  in  its  immature 
state  in  certain  fish. 

Tape-worms  are  very  common  in  dogs;  some  observers  claim  as  high 
as  54  per  cent,  of  all  animals.  In  Europe  all  varieties  of  the  parasites 
seem  to  occur  according  to  different  speaking  countries.  The  record 
given  by  Schones  is  as  follows:  Hunting  dogs  52.94  per  cent,  were  affected 
mostly  with  Taenia  serrata;  butchers'  dogs  GG.6G  per  cent.,  mostly  Taenia 
marginata;  watch  dogs  confined  to  the  yards  and  grounds  around  build- 
ings 40.44,  mostly  Taenia  cucumerina;  work  dogs  used  to  pull,  72.22, 
mostly  Taenia  marginata;  sheep  dogs,  57.14  were  affected  not  only  with 
Taenia  coenurus  to  the  extent  of  7.14,  but  were  also  infected  with  Taenia 
marginata.  Taenia  serrata.  Taenia  cucumerina;  pet  dogs  70.37,  of  which 
36  had  Taenia  marginata.  Taenia  cucumerina  and  15.74  Taenia  serrata. 


Fig.  47. — Taenia  echinococcus ;   mucous  membrane  of  a  portion   of   the   intestine  covered  with  the 

parasites. 

The  writer  finds  in  the  United  States  by  far  the  most  prevalent  is  the 
Taenia  cucumerina,  occurring  in  eighty-two  of  these  cases.  Taenia  serrata 
ten,  and  marginata  only  in  two  instances,  and  Taenia  echinococcus  never 
observed. 

There  is  no  question  that  one  individual  is  attacked  to  a  greater 
extent  than  others,  and  the  parasite  finds  more  favorable  conditions  in 
the  mucous  membrane  of  the  intestine  of  certain  animals.  The  parasites 
may  be  found  in  enormous  numbers,  particularly  the  Echinococcus 
when  they  cover  the  mucous  membrane  and  give  it  a  velvety  appearance 
(Fig.  47). 

Clinical  Symptoms. — "When  tape-worms  are  present  they  generally 
cause  more  or  less  disturbance  in  the  host,  ^^cry  decided  symptoms, 
such  as  chronic  intestinal  catarrh,  can  sometimes  be  attributed  di- 
rectly to  the  presence  of  the  parasites.  Infected  animals,  as  a  rule,  are 
restless,  great  eaters,  and  in  spite  of  the  amount  of  food  they  cat -they 
remain  thin.     Often  they  produce   the   same   symptoms   as   ascarides, 


T.EXIA  91 

but,  as  a  rule,  the  tape-worm  causes  much  more  troul)le  than  the  round 
worms.  Schieferdecker  found  that  in  the  duodenum,  where  the  Taenia 
cucumerina  are  generally  found,  the  mucous  membrane  had  numerous 
small  tunnels  through  which  the  taenia  passed  in  and  out,  and  caused  a 
peculiar  hypertrophy  of  the  papilla?;  in  some  cases  they  were  four  or 
five  times  their  own  length.  In  some  cases  Lieberkuhn's  glands  were 
sunken  and  collapsed  and  in  several  cases  had  completely  disappeared. 
The  Taenia  echinococcus,  when  they  are  present  in  large  numbers, 
cause  great  irritation  of  the  intestines,  with  hemorrhagic  infarction  of 
the  tissues.  In  nervous  animals  they  cause  epileptic  spasms  or  even 
symptoms  of  rabies,  such  as  a  change  of  voice,  paralysis  of  the  lower 
jaw,  dulness  and  indifference  to  surroundings;  Friedberger  and  Froh- 
ner  have  also  observed  similar  symptoms  in  dogs  that  have  been  af- 
fected with  a  Taenia  cucumerina.  In  rare  instances  the  taenia  have  been 
known  to  perforate  the  intestines.  According  to  the  observations  of 
Cadeac,  the  perforation  was  made  by  two  of  the  Taenia  serrata.  In  a 
great  number  of  instances  it  is  impossible  to  say  positively  that  the 
animal  has  tape-worm  unless  the  segments  are  observed  in  the  faeces, 
and  the  most  dangerous  to  man  (Taenia  echinococcus)  is  extremely  hard 
to  find,  on  account  of  the  small  size  of  the  segments.  The  other  tape- 
worms are  comparatively  easy  to  find,  as  the  segments  are  readily 
seen  on  the  outside  of  the  stools  or  catch  in  the  anus  and  hang  on  the 
hair,  the  dog  frequently  drawing  attention  to  them  by  licking  the  anus 
or  drawing  the  hind  extremity  along  the  floor  by  means  of  the  front 
legs.  In  doubtful  cases  it  is  well  to  give  a  small  dose  of  some  taeniafuge, 
and  the  animal  will  generally  pass  a  few  segments. 

Therapeutics. — The  most  important  of  the  numerous  taeniafuges 
recommended  are  as  follows: 

1.  Extract  of  Male  Fern  (extractum  filix  mas). — According  to  the 
experience  of  the  author,  it  is  the  best  agent  to  use.  It  is  to  be  given 
on  an  empty  stomach  (in  the  morning  being  the  best  time).  In  smaU 
dogs  in  doses  from  0.5  to  1.0  and  in  large  animals  2.0  to  5.0,  in  pill  form 
or  in  capsule.  As  this  drug  has  no  purgative  properties,  it  must  be  followed 
up  in  one  or  two  hours  by  a  dose  of  castor  oil  (30  to  50  grammes).  Male 
fern  is  very  liable  to  deteriorate  if  kept  any  length  of  time.  Therefore 
it  is  wise  to  procure  it  from  a  drug  house  that  can  guarantee  it  is  fresh. 
It  must  be  borne  in  mind  that  male  fern  in  large  doses  is  a  poison,  and 
the  maximum  (4.0)  must  not  be  exceeded  in  a  large  dog.  Gesimer  ad- 
vises filmaron  in  0.2  to  1.0  capsules  or  a  10  per  cent,  solution  of  filmaron. 
This  should  be  given  in  the  morning  on  an  empty  stomach  and  followed 
by  a  dose  of  castor  oil. 

2.  Kamala.— This  is  to  be  given  in  doses  of  2  to  8  gm.,  and  in  large 
animals  up  to  15.0.     The  powder  may  be  rubbed  in  with  a  little  ether 


92  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

and  given  in  capsule  but  when  the  powder  is  bulky,  as  in  large  doses,  it 
may  be  mixed  with  honey  or  syrup.  It  must  be  repeated  in  one  hour 
after  the  first  dose.  As  it  is  a  purgative,  it  is  not  necessaiy  to  follow  it 
up  with  any  other  drug,  which  is  an  advantage,  but  to  completely  empty 
the  intestines  of  the  parasite,  it  is  sometimes  wise  to  follow  it  with  a 
laxative. 

3.  Kusso  (Flores  koso). — This  is  to  be  given  in  doses  from  2.0  to  G.O 
grammes,  diluted  with  milk,  repeated  three  or  four  times  at  intervals  of 
three-quarters  to  an  hour.  OnJy  a  good  result  can  be  expected  when 
the  drug  is  fresh.  This  should  be  mixed  with,  or  followed  by,  a  small 
quantity  of  castor  oil. 

4.  Areca  Nut. — The  pulverized  areca  nut  is  administered  in  from 
1.0  to  4.0  in  capsule  mixed  with  honey  or  butter,  followed  by  a  laxative. 
Schiel  advises  a  combination  of  areca  nut  and  kamala.  Areca  nut  is 
frecjuently  vomited  and  must  be  given  with  raspberry  syrup  or  some 
other  sweet  syrup,  which  generally  prevents  it  Ijeing  vomited. 

5.  Chloroform. — 1.0  to  4.0  should  be  shaken  up  with  castor  oil  and 
given  at  once;  the  chief  objection  is,  it  is  very  apt  to  be  vomited. 

Pomegranate  (Cortex  granate). — In  the  shape  of  the  macerated  de- 
coctions, 25  to  00  seeds  (pumpkin  seeds  crushed  and  macerated  in  hot 
water).  Oxide  of  copper  in  doses  of  0.01  to  0.05  daily  for  several  days. 
Turpentine  2.0  to  4.0  beaten  up  in  the  yolk  of  an  egg,  daily  for  three  days. 
Benzine  pelletierum  tannicum,  strontium  lacuticum,  creolin,  naphthol 
are  taeniafuges,  but  are  only  used  to  a  slight  extent,  as  they  are  much 
less  efficient  than  the  first  preparations  mentioned. 

After  the  animal  has  passed  the  parasites  they  ought  to  be  picked 
up  on  a  shovel  or  other  object  and  put  in  the  fire  to  destroy  the  segments, 
especially  if  you  have  reason  to  suspect  that  the  Taenia  echinococcus  is 
present,  on  account  of  the  danger  to  man. 


I^.     01.  resin,  felix  mas,  0.75     to  1.0 

Areca  semina  pulv.,  1.0       to  2.0 

F.  M.  Capsule  No.  1. 

Sig. — Give  on  an  empty  stomach  followed  l)y  castor  oil. 

I^.     01.  re.sin.  feli.x  mas,  1.0      to  4,0 

F.  M.  Capsule  No.  1. 

Sig  — Give  on  an  empty  stomach. 

I^.     Kamala,  1.0      to  2.0 

Anipsthesin,  0.15    to  0.2 

F.  M.  Capsule  No.  1. 

Sig. — Give  on  an  empty  stomach 


T,t:xiA 


93 


0 

7 

1 

0 

[tc 

4 

0 

to 

40 

0 

I}.  01.  res.  fclix  mas, 
Kamala, 

Ol.  olivjp,  1  drop. 
F.  M.  Capsule  No   1. 

I^.  Chloroform,  2.0 

01.  ricini,  30.0 

Sig. — Give  in  two  doses  one  week  apart. 
I^.  Areca  semina  piilv.,  1.0     [to  3.0 

Sig. — In  capsule,  honey  or  milk. 

I^.  Kousso,  4.0    to     6.0 

Mel. 

G.  S.  teaspoonful. 
F.  M.  Electuray. 
Sig.— To  be  given  in  two  doses,  one  week  apart. 


Oxyuris  Vermicularis. — By  this  name  (Fig.  48) 
we  mean  a  small,  white,  thread-like  round  worm. 
The  female  is  from  9  to  13  mm.  in  length  and  the 
male  from  3  to  4  mm.  in  length.  This  parasite  is 
rarely  found  in  the  dog.  They  are  generally  located 
in  the  rectum  and  the  lower  large  intestines.  They 
cause  great  itching  of  the  anus,  and  the  animal  is 
observed  to  lick  that  part  constantly  and  also  to 
frequently  pull  the  hind-quarters  on  the  floor. 

These  harmless  parasites  are  removed  by  cly- 
sters composed  of  solutions  of  salt  water,  quassia 
bark,  vinegar  or  a  weak  solution  (1-2000)  of  corro- 
sive sublimate. 

Dochmius. — Dochmius  (Anchylostomum  uncin- 
aria)  (Fig.  49)  is  a  small,  thread-like  parasite  which 
belongs  to  the  family  of  strongylides  (palisade  worm) . 
The  end  of  its  head  is  like  a  bell-shaped  capsule, 
having  two  small,  curved  teeth  on  its  dorsal  border 
and  four  teeth  on  its  ventral  border.  By  means  of 
the  bell-shaped  disk  and  the  teeth  on  the  inner  part 
of  its  mouth  it  sucks  and  buries  its  head  into  the 
mucous  membrane  of  the  intestine  and  sucks  blood. 
Three  forms  of  this  parasite  are  found  in  the  small 
intestine  of  the  dog  and  are  described  as  follows: 
the  Dochmius  duodenalis,  the  male  10  mm.  long, 
the  female  12  to  18  mm.  long;  the  Dochmius  trigo- 
nocephalus,  the  male  is  9  to  12  mm.  wide,  the 
female  15  to  20  mm.  wide,  and  the  Dochmius  steno- 
cephalus,  the  male  is   G   to  8  mm.   long  and  the 


Fi<;.  48. — OxyurLs  ver- 
micularis :  a,  magnified 
diagram  of  the  female;  b, 
the  male,  magnified;  c, 
natural  size  of  the  female; 
d,  natural  size  of  the  male 
{Vierordt). 


94  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

female  is  8  to  10  mm.  long.  The  Dochmius  duodenalis  is  the  parasite 
that  observers  have  named  as  causing  the  disease  known  as  Egyptian 
chlorosis.  This  disease  is  indicated  in  man  by  general  anaemia.  The 
eggs,  which  are  oval,  are  jsassed  in  enormous  numbers  in  the  faeces  of 
affected  persons,  and  lie  on  the  leaves  of  acjuatic  plants  or  the  moist 
ground,  and  are  taken  up  in  the  drinking  water,  food  or  eating  of 
grass  by  dogs,  reach  the  intestines  of  the  animal  and  the  parasite  soon 
matures.  One  liranch  of  the  Dochmius,  seen  in  Austria,  Italy  and  Japan, 
Dochmius  uncincoriasis,  causes  great  disturbance,  particularly  in  hunt- 
ing dogs. 

Animals  affected  with  this  parasite  become  anaemic,  weak  and 
thin,  develop  hemorrhagic  enteritis  and  catarrhal  pneumonia  and  have 
a  peculiar  discharge  from  the  nose,  of  a  thin,  bloody  mucus  (Megnin, 
Ilaillet).     Peregand  found  these   cases   generally  had   piroplasma   with 


'a- 


Fig.   49. —  a,  Male;  b,  female  (natural  size);  c,  magnified  head  (Jaksch). 

the  other  symptoms.  There  are  also  oedematous  swellings,  ulcerations 
or  gangrenous  swellings  of  the  skin,  with  intense  cachexia. 

Therapeutics. — The  treatment  consists  in  the  administration  of 
tseniafuges,  felix  mas,  kamala,  cadeot  combined  with  calomel.  Megnin 
uses  calomel  and  arsenic,  the  latter  in  0.005  to  0.01  doses.  Besides  this, 
give  easily  digested  and  nutritious  food,  milk,  and  eggs.  The  faeces  of 
all  affected  animals  should  be  burned  and  the  stools  and  benches  where 
the  dogs  sleep  should  be  cleaned.  Drinking  water  to  be  from  a  spring, 
or  else  filtered  or  boiled. 

The  presence  of  this  parasite  is  recognized  in  the  same  way  as  one 
would  locate  the  taenia,  that  is,  by  the  presence  of  the  parasite  or  eggs 
in  the  faeces.  They  are  easily  recognized,  the  eggs  being  similar  to  the 
ascarides. 

Besides  the  already  mentioned  parasites,  we  also  find  the  Distoma 
echinatum  (Generali  and  Ratz)  and  the  Distoma  heterophytes,  found  by 
Jaiiyen  in  Japan  and  by  Loots  in  Egypt,  in  the    intestines.     The  Tri- 


PERITONITIS 


95 


chocephalus  depressiusculus  is  found  in  the  caecum  (Fig.  50) .  This  parasite, 
according  to  a  number  of  authors,  may  produce  a  catarrh  or  hemorrhagic 
condition  of  the  intestines  and  invagination  of  the  caecum.     Animals  af- 


FiG.  50. — Wall  of  the  csecum  with  numerous  Trichocephalus  depressiusculus. 

fected  with  these  parasites  suffer  from  dochmiasis  or  anaemia.  This 
distomum  heterophytes  was  found  in  an  animal  presenting  symptoms  of 
rabies. 

DISEASES  OF  THE  PERITONEUM. 

Inflammation  of  the  Peritoneiun — Peritonitis. 

Etiology. — Peritonitis  is  comparatively  rare  in  dogs  and  is  generally 
seen  as  a  secondary  disease;  due  originally  to  some  irritation  or  in- 
jury of  some  of  the  other  organs  of  the  abdomen,  the  stomach,  intes- 
tines, spleen,  liver,  kidneys,  bladder,  prostate,  or  the  uterus.  From 
toxic  gastro-enteritis,  ulceration  of  the  stomach  or  intestines,  accumula- 
tions of  faecal  matter  in  the  intestines;  from  metritis  or  parametritis 
after  labor;  from  inflammation  or  abscess  of  the  liver;  from  purulent  inflam- 
mation of  the  kidneys,  or  from  purulent  pleuritis;  from  rupture  of  the  ab- 
dominal viscera  and  the  escape  of  food,  faeces,  gas,  bile,  pus,  parasites 
perforating  the  intestinal  mucous  membrane,  and  in  rare  instances  from 
the  presence  of  parasites  (Plerocerooides  barletti)  in  the  abdominal 
cavity.  It  may  also  occur  from  a  general  inflammation  of  all  the  ser- 
ous membranes  of  the  body,  as  is  sometimes  observed  in  infectious  dis- 
eases; to  pyaemia  or  metastatic  peritonitis;  from  the  breaking  down  of 
tubercular  masses  that  have  collected  on  the  peritoneum,  or  from  can- 
cer.    Primary  peritonitis  is  always  caused  by  some  injury  to  the  ab- 


96 


DISEASES  OF  THE  DIGESTIVE  APPARATUS 


dominal  wall,  shocks,  blows,  or  by  penetration  of  the  abdominal  walls, 
or  after  some  opei'ations  and  from  cold  (rheumatic  peritonitis). 

Pathological  Anatomy. — According  to  the  extent  of  the  disease  we 
call  it  either  partial  (circumscribed)  or  general  peritonitis  (diffused); 
according  to  its  course,  acute  or  chronic;  and  according  to  its  character, 
we  call  the  exudate  serous,  fibrinous,  purulent,  putrid,  or  hemor- 
rhagic. The  purulent  form  of  the  disease  is  the  most  common  and  on 
account  of  the  extensive  irritation  that  any  inflammation  causes  in  the 
peritoneum,  it  is  apt  to  take  the  diffuse  form  of  the  disease;  and  while 
it  may  start  originally  as  circumscribed,  the  disease  generally  becomes 


Fig.  51. — Section  through  the  abdomen  of  the  dog  showing  the  distribution  of  the  peritoneum: 
a,  kidney;  b,  aorta;  c,  vena  cava;  d,  intestine;  d' ,  duodenum;  e,  pancreatic  gland;/,  spleen;  g,  liver;  h, 
subperitoneal  fat. 


diffuse  in  a  short  time.  The  peritoneum  is  first  injected  and  ecchymosed, 
becoming  dull  red  and  velvety,  due  to  the  removal  of  the  endothelium 
and  partially  to  the  exudate,  which  contains  more  or  less  fibrinous  sub- 
stances. This  collects  as  a  thick  layer  over  the  peritoneum  and  the 
exudate  unites  the  intestines  to  each  other  or  to  the  different  organs 
in  the  abdominal  cavity,  or  even  to  the  sides  of  the  abdominal  wall.  In 
recent  cases  these  adhesions  are  easily  pulled  apart,  but  later  on  they 
become  firmly  united  and  are  very  hard  to  separate  (adhesive  i^erito- 
nitis).  There  is  also  a  quantity  of  fibrinous  exudate  thrown  out,  which  is 
accompanied  by  more  or  less  liquid.  This  varies  from  a  small  quantity 
to  several  litres.  There  is  always  some  oedema  of  the  serous  wall  of 
the  intestines,  which  becomes  soft  and  friable   (Fig.   51). 

The  chronic  form  may  start  out  as  such  at  the  onset,  biit  generally 
it  follows  an  acute  attack,  the  peritoneum  becomes  very  much  thickened 


PERITONITIS  97 

and  adhesions  form,  with  the  intestines  and  the  adjacent  organs,  at  times 
contracting  the  intestinal  walls  and  causing  a  lessening  of  the  diameter  of 
the  intestinal  canal.  In  the  chronic  form  the  exudate  is  not  purulent,  as 
a  rule,  but  is  composed  of  a  thick,  hemorrhagic  serum.  In  the  dog,  we 
sometimes  observe  a  form  of  ascites  (see  under  that  head)  in  which  we 
have  a  chronic  thickening  of  the  peritoneum  and  a  collection  of  a  turbid, 
fibrinous  exudate  (inflammator}'  ascites). 

Circumscribed  Peritonitis  may  be  caused  by  any  irritation  of  the 
viscera,  such  as  inflammatory  and  suppurative  processes  of  the  stomach, 
intestines  or  uterus,  classed  as  perigastritis,  perienteritis  and  perime- 
tritis and  the  irritation  extend  to  the  serous  coat.  We  often  find  small 
circumscribed  deposits  on  the  liver,  occasionally  on  the  spleen  and  other 
alDdominal  organs,  that  have  originated  from  slight  peritonitis.  In 
cases  where  there  is  a  small  amount  of  purulent  peritonitis,  the  inflam- 
mation remains  in  one  locality  and  becomes  encysted.  As  a  rule,  with 
the  exception  of  circumscribed  peritonitis,  death  generally  occurs  in  the 
first  stages  of  the  disease,  and  it  is  only  in  the  mild  cases,  where  the 
exudation  is  very  slight,  that  there  is  any  chance  of  recovery.  The  exu- 
date breaks  down  and  is  re-absorbed  but,  as  a  rule,  there  is  such  an  ex- 
tensive alteration  and  adhesion  formed  that  it  is  only  in  rare  cases  that 
the  animal  ever  is  restored  to  perfect  health. 

Clinical  Symptoms  and  Course  of  the  Disease. — (1)  Acute  diffuse 
peritonitis.  When  the  disease  is  caused  by  some  traumatism,  by  perfora- 
tion, either  from  the  intestines  or  externally,  the  symptoms  appear  very 
rapidly.  At  first  there  is  colic,  great  restlessness,  and  a  stiff,  unnatural 
gait.  The  posterior  extremities  are  carried  out  from  the  body  and  are 
not  flexed.  The  animal  groans  and  cries.  The  pain  is  continual,  the 
abdomen  is  very  sensitive  on  manipulation,  the  slightest  touch  produces 
intense  pain.  There  are  some  cases  in  this  disease,  however,  where  the 
animal  shows  very  little  pain,  but  this  is  only  seen  where  there  is 
great  debility.  The  abdomen  becomes  distended  in  the  early  stages  of 
the  disease,  due  to  inflation  of  the  intestinal  tract  from  gas  and  later  on 
by  the  collection  of  the  exudate.  When  the  abdomen  is  distended,  if 
gas  is  present,  on  percussion,  the  sound  is  hollow^,  and  when  exudate  is 
present,  the  sound  is  dull.  The  exudate,  of  course,  lies  on  the  floor  of  the 
abdominal  cavity;  but  where  the  exudate  forms  very  rapidly,  the  whole 
abdomen  is  filled  up,  pressing  on  the  diaphragm,  compressing  the  lungs 
and  causing  great  dyspncea. 

In  the  early  stages  the  abdomen  is  tucked  up,  the  walls  tense,  firm 
and  painful  to  the  touch,  and  it  is  generally  some  time  before  the  abdomen 
begins  to  enlarge  from  the  collection  of  the  exudate.  As  a  rule,  the  bowels 
are  constipated  except  where  there  has  been  some  diarrhoea,  or  diar- 
rha'a  alternated  with  constipation,  present  before  the  disease  started, 
7 


93  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

which  is  seen  in  those  cases  where  there  is  ulceration  and  perforation  of 
the  mucous  membranes.  Vomiting  is  always  present,  the  vomited 
matter  being  greenish-yellow  mucus,  and  in  the  latter  stages  we  fre- 
quently find  faecal  matter  in  the  vomited  material;  the  urine  is  lessened 
in  amount  and  contains  a  large  amount  of  indican.  There  is  total  loss 
of  appetite.  The  temperature  rises  to  40°  C.  or  above.  If  the  disease  is 
not  so  severe  as  to  cause  death  in  a  day  or  two  the  temperature  fluctu- 
ates, being  high  at  one  part  of  the  day  and  then  it  becomes  subnormal, 
its  character  being  remittent.  The  pulse  is  fast,  thin  and  wiry,  and 
finally  imperceptible. 

The  majority  of  cases  are  fatal,  the  animals  dying  in  from  one  day 
to  a  week,  according  to  the  intensity  of  the  disease.  They  usually  die  in 
a  condition  of  collapse;  in  rare  cases  from  heart-failure  or  suffocation 
from  the  rapid  collection  of  the  exudate.  The  most  rapidly  fatal  cases 
are  those  due  to  the  perforation  with  septic  infection. 

Circumscribed  or  Chronic  Peritonitis  produces  less  marked  symp- 
toms and  is  harder  to  recognize,  the  symptoms  of  diffuse  chronic  peri- 
tonitis being  those  of  ascites,  and,  as  a  rule,  not  diagnosed  except  on 
post-mortem.  The  best  way  to  confirm  a  diagnosis  is  to  puncture  the 
abdomen  with  a  small  trocar  and  see  the  character  of  the  fluid. 

Therapeutics. — Remove  the  cause  if  possible;  if  this  cannot  be  ac- 
complished by  surgical  interference,  acute  diffuse  peritonitis  should  be 
treated  with  constant  applications  of  cold  water  compresses  to  the  ab- 
domen, and,  if  the  irritation  is  very  intense,  the  application  of  a  covmter- 
irritant  such  as  frictions  of  camphor  oil,  mustard  poultices  or  mustard  oil; 
the  latter  is  the  best.  Take  30  to  50  grammes,  of  a  mixture  composed  of 
mustard  oil,  10  parts  and  olive  oil  100,  rubbing  it  well  into  the  abdomen; 
applications  of  hot  water  to  the  abdomen  by  means  of  the  priessnitz 
compress  are  also  useful.  Opium  is  to  be  given  internally  in  doses  of 
0.1  to  0.5  grammes;  laudanum  1.0  to  5.0,  and  where  there  is  collapse 
give  whiskey  and  spirits  of  camphor.  If  there  is  any  obstruction  of  the 
bowels,  give  injections  of  warm  water  or  subcutaneous  injections  of  phy- 
siological salt  solution.  The  exudate  should  be  removed  by  puncture 
of  the  abdomen,  but  this  is  not  to  be  done  until  the  acute  symptoms 
have  subsided.  It  must  always  be  borne  in  mind  (and  this  holds  good 
in  inflammation  of  other  serous  membranes)  that  the  production  of  a  serous 
exudate  is  a  process  that  tends  to  lessen  the  acuteness  of  the  existing 
conditions,  because  the  liquid  helps  to  keep  the  intensely  inflamed  parts 
separate  and  prevents  frictions  and  its  complicating  inflammation,  hence 
it  should  not  be  removed  too  early  but  when  the  exudate  is  suspected  to 
be  purulent  and  by  means  of  an  explorative  puncture  has  been  proven  to 
1)0  so,  a  laparotomy  must  be  performed,  and  the  whole  abdominal  cavity 
washed  out  with  a  weak  solution  of  salicvlic  or  boric  acid.     When  the 


ABDOMINAL  DROPSY 


99 


animal  shows  signs  of  recovery,  the  diet  must  be  carefully  regulated,  at 
first  milk,  or  thin  soup,  as  the  animal  is  very  apt  to  vomit.  Then  the 
lightest  diet,  soup,  milk,  juice  of  beef,  a  small  quantity  of  lemon  juice  can 
be  administered,  a  teaspoonful  at  a  time,  or  a  teaspoonful  of  essence  of 
pepsin. 

Abdominal  Dropsy. 

(Hydrops  Ascites;  Ascites;  Hydrops  Abdominis;  Hydrops  Peritonei.) 

By  this  is  meant  a  collection  of  serous  liquid  in  the  abdominal  cavity 
that  originates  without  inflammatory  symptoms,  being  due  to  transuda- 
tion. The  amount  of  liquid  collected  varies  very  much.  In  some  cases 
there  are  only  a  few  spoonfuls,  in  others  15  to  20  litres  of  liquid. 

The  color  of  the  liquid  is  sometimes  as  clear  as  water,  but  generally 
it    is    reddish-yellow.      It    may    also    be    filled    w-ith    flakes   of    fibrin, 


Fig.  52. — Dog  with  ascites. 

which  indicate  chronic  peritonitis,  or  turbid  as  milk  (chylous  ascites). 
When  exposed  to  the  atmosphere  it  usually  remains  fluid  and  only  in 
rare  instances  it  becomes  firm  and  jelly-like.  It  is  thin  and  watery  and 
slightly  sticky  when  pressed  between  the  fingers  and  about  the  specific 
gravity  of  blood  serum.  At  first  the  peritoneum  is  normal,  but,  if  this 
condition  lasts  some  time,  the  peritoneum  becomes  macerated,  is  pale  or 
dull  white,  and  finally  a  general  degeneration  sets  in.     When  the  animal 


100  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

has  been  repeatedly  punctured,  inflammatoi-y  processes  may  take  place, 
and  are  followed  by  adhesions.  The  abdominal  organs  become  anaemic 
and  freciucntly  dropsical  (Fig.  52). 

Etiology. — Ascites  never  appears  as  an  independent  disease,  but 
must  be  regarded  as  a  symptom  of  another  disease.  As  the  peritoneal 
veins  belong  to  the  mesenteric  system,  any  obstruction  of  the  portal 
veins  cause  these  serous  collections,  for  instance,  in  cirrhosis  of  the  liver,  or 
tumors  of  that  organ,  or  from  compression  of  the  mesenteric  veins  by  tu- 
mors, abscesses,  etc.  Ascites  is  also  seen  as  a  symptom  of  general  dropsy  of 
the  kidneys  or  lungs,  and  from  defective  action  of  the  heart.  It  may  also 
be  caused  by  local  diseases  of  the  peritoneum,  such  as  tuberculosis,  car- 
cinoma, or  from  chronic  inflammation  between  transudate  and  inflam- 
matory exudates.  In  young  animals  ascites  may  develop  without 
any  other  complications  or  cause  and  may  make  a  complete  recovery 
(Hutyra  and  Marek)- 

Clinical  Symptoms. — The  chief  clinical  symptom  of  this  disease 
is  the  accumulation  of  fluid  in  the  abdominal  cavity.  Small  amounts 
very  frequently  are  not  noticed  and  in  fact,  cannot  be  determined  by 
any  means  except  by  tapping.  When  there  is  a  considerable  collection 
of  serous  fluid,  the  abdominal  wall  is  distended,  and,  from  being  in  the 
lower  portion  of  the  abdomen,  the  cross-section  outlines  of  the  trunk 
resemble  those  of  a  pear.  There  is  a  peculiar  sunken  appearance  of 
the  flanks  (see  Fig.  52).  When  the  tips  of  the  fingers  are  struck  against 
the  distended  abdomen,  there  is  a  fluctuating  movement;  and  when  there 
is  a  large  quantity  of  fluid  present,  the  splashing  sound  of  the  fluid  can 
sometimes  be  heard  when  the  side  of  the  abdomen  is  struck  sharply 
with  the  flat  of  the  hand.  By  percussion,  we  can  tell,  to  a  certain 
extent,  the  amount  of  the  fluid  present.  The  animal  should  be  made 
to  stand,  so  that  all  the  fluid  lies  in  the  base  of  the  abdomen.  By 
percussing,  beginning  at  the  lower  part  of  the  abdomen  and  moving- 
upward  on  the  wall  where  there  is  fluid  present,  we  will  get  a  dull  sound ; 
and  when  the  line  of  fluid  is  passed,  we  get  the  intestinal  or  tympanic 
sound.  It  is  very  important  that  the  animal  should  be  in  a  standing 
position,  as  it  can  be  readily  understood  that  when  the  animal  is  lying  on 
its  side,  the  fluid  gravitating  to  the  lower  side,  we  would  get  a  clear  tym- 
panic sound  all  over  the  abdominal  wall  on  the  upper  side  and  still 
have  a  large  quantity  of  fluid  in  the  cavity. 

The  higher  the  fluid  collects,  the  greater  is  the  pressure  on  the  ab- 
dominal organs,  and  the  consequent  pressure  on  the  diaphragm,  causing 
interference  with  normal  respiration.  The  urine  is  generally  nor- 
mal, but  reduced  in  quantity,  and  the  quantity  of  the  accumulated 
fluid  pressing  on  the  bladder  may  sometimes  cause  involuntary  emp- 
tying of  the  bladder.     In  the  later  stages  osdematous  swellings  appear 


ABDOMIXAL  DROPSY  101 

in  the  extremities,  or  we  may  find  a  general  dropsy,  the  digestion 
is  impaired,  and  the  bowels  disturbed.  In  the  majority  of  cases  diar- 
rhoea is  present,  with  occasionally  vomiting.  AVhile  it  seems  very 
easy  to  make  a  diagnosis  when  the  above  symptoms  are  present,  still 
the  following  diseases  may  present  several  or  all  of  the  symptoms  above 
described. 

1.  Acute  or  Chronic  Peritonitis. — "\Mien  one  reads  the  sj'mptoms 
of  acute  peritonitis  the  diseases  can  be  readily  separated,  but  in  the 
latter  part  of  the  disease,  when  the  effusion  has  collected,  or  where  the 
chronic  stage  of  peritonitis  is  present,  it  is  a  little  difficult  to  separate 
them,  the  only  positive  means  being  to  puncture  the  walls  with  a  small 
trocar  (hypodermatic)  and  obtain  a  small  quantity  of  the  fluid,  and  it  is 
rather  common  to  see  ascites  associated  with  chronic  peritonitis. 

2.  Fatty  Deposits  in  the  Abdomen. — This  disease  is  quite  frequently 
present  in  old  dogs;  but  a  differential  diagnosis  can  be  made  from 
the  fact,  that,  where  there  are  enormous  collections  of  fat  present,  the 
abdomen  is  round  in  appearance,  but  does  not  become  pendulous,  whether 
the  clog  is  standing  or  recumbent.  It  is  well  not  to  puncture  in  these 
cases,  as  it  gives  no  information,  and  may  cause  internal  hemorrhage. 

3.  Abnormal  Collections  of  Urine  in  the  Bladder. — In  these  cases  we 
feel  a  ball-shaped  body  in  the  posterior  portion  of  the  abdomen;  this 
swelling  does  not  follow  the  changes  in  the  position  of  the  body,  and  is 
not  indicated  by  percussion.  A  good  way  to  make  a  differential  diag- 
nosis is  to  lift  up  the  animal  by  the  posterior  extremities,  and  if  it  is  as- 
cites the  liquid  will  settle  on  the  diaphragm  and  interfere  with  respira- 
tion; if  the  bladder  is  filled,  we  do  not  have  the  dull  percussion  sound. 

To  further  confirm  the  diagnosis  pass  the  catheter. 

4.  Distention  of  the  Bowels  with  Gas  (Meteorismus) . — In  this  in- 
stance, there  is  an  absence  of  the  fluctuation  and  the  clear  tympanic 
sound  all  over  the  abdomen. 

5.  Collections  of  Urine  in  the  Abdomen  after  Rupture  of  the  Blad- 
der.— On  the  passage  of  the  trocar,  the  clear  urine  is  passed  which  can 
easily  be  recognized  by  the  color  and  odor,  with  absence  of  urine  on  cathe- 
terization, and  ursemic  fever,  or  convulsions. 

6.  In  Advanced  Gestation. — By  careful  manipulation  the  foetuses 
can  be  easily  distinguished  in  the  abdomen. 

Besides  the  above  conditions,  we  may  also  have  to  distinguish  be- 
tween ascites  and  tumors  of  the  abdominal  cavity  (hydrometra,  pyome- 
tra).  All  these  affections  can  be  recognized  by  carefully  considering 
the  history  of  the  case  and  the  accompanying  symptoms. 

It  is  always  well  to  carefully  study  the  exciting  cause  of  the  disease, 
as  the  course  of  treatment  depends  on  it.  This,  however,  is  rather 
hard  to  do,  for,  as  a  rule,  the  collection  of  fluid  is  caused  by  the  dam- 


102  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

ming  or  interference  in  the  mesenteric  system,  by  cirrhosis  of  the 
liver,  or  some  interference  in  the  portal  system.  These  are  likely  to 
improve  with  tapping  and  symptomatic  treatment.  But  in  anasarca, 
hydrothorax,  general  dropsy  due  to  a  weak  heart,  or  valvular  affections 
of  that  organ,  disorders  of  the  lungs  or  kidneys,  hydrsemia  or  marasmus; 
it  depends  to  a  large  extent  on  whether  we  can  either  restore  the  af- 
fected organ  to  a  normal  condition,  for  if  they  are  permanently  affected, 
the  condition  is  generally  chronic.  Quite  often  we  find  affections  of 
the  liver  and  spleen  that  are  never  recognized  during  life.  To  make 
an  examination  of  these  organs  it  is  well  to  do  it  just  after  the  animal 
has  been  tapped  and  the  fluid  has  been  removed;  the  walls  of  the 
abdomen  are  collapsed,  and  the  organs  can  be  manipulated  with  greater 
ease  at  that  time.      If  tumors  are  present,  they  are  readily  recognized. 

Notwithstanding  all  the  etiological  conditions  described,  there  are 
often  cases  where  the  cause  can  only  be  guessed  at. 

Prognosis  and  Therapeutics. — As  a  rule,  the  prognosis  is  unfavor- 
able as  we  are  unable  to  remove  the  exciting  cause.  The  cases  that  re- 
cover are  generally  in  young  dogs  and  the  dropsy  is  the  only  existing  con- 
dition. In  the  majority  of  cases,  the  ascites  disappears  spontaneously. 
Our  first  effort  is  to  remove  the  exciting  cause,  if  it  is  recognized;  and 
then  to  remove  the  dropsical  effusion,  either  medicinally  or  surgically. 
At  the  same  time  the  animal  should  be  well  fed  on  highly  nitrogen- 
ous, easily  digested  food  and  tonics  (see  anaemia).  This  can  be  done  in 
the  following  ways: 

1.  By  Laxatives. — This  method  is  t;o  be  followed  where  there  is  con- 
stipation associated  with  the  disease.  Saline  purgatives  are  the  best, 
glauber  salts,  epsom  or  rochelle  salts,  such  laxatives  as  jalap,  podophyl- 
lum, castor  oil,  are  contraindicated,  as  they  irritate  the  stomach  and 
destroy  the  appetite  and  weaken  the  animal.  The  salines  are  indicated, 
only  in  sufficient  doses,  to  cause  a  slight  laxative  action,  so  as  not  to 
interfere  with  the  appetite. 

2.  Diuretics. — This  form  of  treatment  has  always  been  popular  to 
be  given  and  is  still  much  used.  These  are  only  used  where  there  is  posi- 
tive evidence  that  there  is  no  previous  irritation  of  the  kidneys.  The 
best  are  the  vegetable  diuretics,  such  as  digitalis,  strophanthus,  caffeine, 
salicylate  of  soda,  oil  of  juniper,  liq.  potassii  acetas;  among  the  more 
recent  diuretics  are  theocin,  theobromin,  soda  salicylate  4.0  to  6.0  in 
sol.,  diuretin  4.0  to  CO;  the  best  saline  drugs  are  acetate  of  potassium 
and  sodium. 

I^.     Tine,  digitalis  fol.,  1.0 

Liq.  potas.sium  acetate,  30.0 

Sig. — One  tea.spoonful  throe  times  daily. 


ABDOMINAL  DROPSY  103 


.     Agurin, 

0.1 

to      .0-1 

Caffoine-sodium-salicylas, 

2.0 

to  5.0 

Sacharrum  alba. 

5.0 

M.  F.  et  divid  charter  No    X. 

Sig. — One  powder  three  times  daily. 

I^.     Agurin,  2         to  6.0 

Aqua  menth.  pip,  150.0 

Sig. — Tablespoonful  three  times  daily. 

3.  Hydrochlorate  of  Pilocarpine. — We  may  sometimes  obtain  very 
good  results  with  this  drug.  The  injection  of  the  solution  subcutane- 
ously  is  made  once  daily  (0.005  to  0.01  of  water).  Zahn  gave  three  drops 
of  the  1  per  cent,  solution  on  the  tongue,  three  times  daily.  The  admin- 
istration of  this  drug  causes  the  amount  of  saliva  to  be  greatly  increased, 
and  the  amount  of  fluid  exudates  to  be  very  much  decreased.  Frohner 
recommends  Arecolin. 

4.  Tapping  or  Puncture  of  the  Abdomen. — This  is  indicated  where 
there  is  a  large  collection  of  fluid,  that  is  pressing  on  the  diaphragm, 
and  also  used  as  a  diagnostic  procedure.  Whether  it  is  best  to  re- 
move the  fluid  in  all  cases  is  a  question  that  has  not  yet  been  decided; 
yet  the  writer  is  of  the  opinion  that  the  fluid  should  be  removed,  pro- 
vided the  animal  is  roljust  and  not  too  old,  especially  as  the  operation  is 
comparatively  harmless,  and  has  the  advantage  over  purgatives  and 
diuretics  in  that  the  accumulation  is  removed  ciuickl3\  In  a  great 
number  of  cases  the  fluid  has  not  accumulated  after  one  or  more  punc- 
tures. Friedberger  and  Frohner  have  seen  old  dogs  that  have  died  dur- 
ing, or  shortly  after,  the  operation.  The  method  of  puncturing  or  tap- 
ping is  to  take  the  ordinary  trocar,  a  narrow  caliber  one  is  best,  even  if 
it  takes  a  long  time  to  drain  out.  We  also  avoid  unconsciousness,  which 
sometimes  occurs  where  a  large  quantity  is  drained  out  too  suddenly. 
During  the  operation  the  pulse,  respiration,  and  general  appearance 
of  the  animal  must  be  watched  carefully,  in  case  the  animal  might  col- 
lapse from  the  shock.  In  such  an  event,  the  trocar  must  be  removed 
instantly  and  a  subcutaneous  injection  of  spirits  of  camphor  must  be 
given.     The  trocar  should  always  be  boiled,  immediately  before  using. 

The  method  of  operating  is  very  simple.  The  place  to  insert  the 
catheter  is  generally  about  the  umbilical  region,  on  or  to  one  side  of  the 
linea  alba.  The  animal  should  be  placed  in  a  standing  position.  Should 
the  canula  become  plugged  either  by  the  omentum  or  intestines  coming 
against  the  opening  of  the  canula,  it  should  be  pulled  downward,  or  moved 
to  one  side  or  introduce  an  elastic  catheter  and  push  them  to  one  side. 
After  the  fluid  has  ceased  to  flow,  remove  the  catheter  and  paint  the 
opening    with  collodion. 


104  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

The  other  changes  in  the  peritoneum  have  no  special  value.  Tu- 
bercular masses,  sarcomas,  and  carcinomas  have  been  already  men- 
tioned; also  parasites.  Plerocercoides  barleti  are  found  free  or  partially 
encysted,  also  the  pentastomum  denticulatum  was  found  by  Rochcfon- 
taine  in  great  numbers  in  the  subperitoneal  cyst  of  the  liver  and  mesen- 
tery, and  here  also  have  been  found  the  bladder  cysts  of  the  taenia 
echinococcus. 

DISEASES  OF  THE  LIVER. 

Catarrhal  Jaundice. 

(Icterus  Catarrhalis;  Icterus  Gastro-duodenalis .) 

Etiology. — In  catarrh  of  the  stomach  we  often  find  symptoms  of 
jaundice  with  that  disease,  especially  where  the  inflammation  of  the 
mucous  membrane  extends  to  the  duodenum,  and  the  ductus  cholcdochus 
l)ccomes  closed  by  the  swelling  of  its  mucous  membranes  and  prevents 
the  exit  of  the  bile.  As  soon  as  such  an  ol)st ruction  occurs,  the  bile  can 
no  longer  flow  into  the  intestines;  it  becomes  stagnant  and  dams  back, 
causing  a  pressure  on  the  bile-ducts,  and  being  unable  to  escape,  it  finally 
enters  the  lymphatic  vessels  of  the  liver,  from  them  into  the  blood  through 
the  thoracic  duct.  After  this  there  follows  a  series  of  symptoms  that 
have  been  named  jaundice  (icterus).  In  the  early  stages  of  the  disease 
we  have  to  deal  with  an  icterus  that  is  produced  by  stagnation  of  the 
bile.  It  has  been  found  by  observers  that  the  pathological  or  artificial 
stoppage  of  the  flow  of  the  bile,  and,  consequently,  damming  back  of 
the  bile,  will  produce  jaundice  in  forty-eight  hours.  This  has  a  number  of 
names — stagnating  icterus,  icterus  of  reabsorption,  or  hepatogenous 
icterus.  While  the  swelling  of  the  mucous  membrane  is  generally  the 
cause  of  this  disease,  still  there  are  a  number  of  other  causes  that  may  also 
produce  it,  such  as  foreign  bodies  in  the  ducts  (parasites,  gallstones,  etc.), 
from  ulceration  of  the  mucous  membrane,  by  the  cicatricial  contraction  of 
tumors,  or  abscesses  in  or  near  the  liver,  from  intestinal  parasites  invad- 
ing the  bile-duct,  from  the  bile  being  very  dense  and  flowing  slowly,  by 
disturbance  of  the  liver  cells  and  the  bile  driven  in  an  opposite  direction 
(Minkowski),  and  diffuse  icterus  (icterus  per  paranedesen) ,  in  disturbance 
of  the  blood  circulation  due  to  throml;)us  in  the  portal  artei'ies,  the  pres- 
ence of  bacteria,  from  the  eating  of  decayed  meat  and  from  certain  in- 
fectious diseases,  in  cases  of  poisoning  from  phosphorus.  The  stop- 
ping of  the  flow  of  bile  sets  up  an  inflammation  of  the  tissues  and  some- 
times forms  abscess  of  the  liver,  but  as  the  great  majority  of  cases  are 
caused  by  the  catarrhal  form,  we  will  desci'ibc  that.  Any  cause  that 
will  produce  catarrh  of  the  stomach  will  finally  produce  icterus,  such  as 


CA  TA  RRHA  L  J  A  UN  DICE  1 05 

improper  food,  especially  when  it  is  frozen;  cold  drinks  after  over-heat- 
ing; salt  meat,  or  salt  fish.  That  form  of  icterus  that  is  so  often  seen 
during  distemper  is  very  likely  to  be  catarrhal. 

Pathological  Anatomy. — The  symptoms  of  catarrh  of  the  duodenum 
are  always  present;  the  vessels  are  more  or  less  injected,  and  the  mucous 
membrane  swollen.  As  a  rule,  the  mouth  of  the  duct  is  closed,  and  it  is 
only  by  very  strong  pressure  on  the  gall  bladder  that  we  are  able  to 
open  it  and  force  the  bile  out  of  the  duct.  In  some  cases  a  white  clot  of 
mucus  is  forced  out  and  when  the  duct  has  been  plugged  up  some  time 
the  bile  is  converted  into  a  syrupy  or  semi-solid  mass,  but  in  the  majority 
of  cases  it  is  due  to  swelling  of  the  intestines  and  not  to  catarrh  of  the 
mucous  membrane  of  the  duct. 

In  some  post  mortems,  we  may  not  find  any  swelling  in  the  region  of 
the  duct,  but  very  frequently  the  post-mortem  changes  are  so  cjuick  as 
to  be  hardly  recognizable  at  the  autopsy.  Another  fact  to  be  taken  into 
consideration,  is  that  the  canal  is  so  very  narrow  in  the  dog  that  it  takes 
a  very  small  amount  of  swelling  to  obstruct  it. 

The  body  of  the  liver  may  be  changed;  it  is  generally  enlarged  and 
anaemic,  and  varies  in  color  from  a  j^ellow  to  a  yellowish-brown.  The 
color  is  irregular  and  it  is  mottled  like  a  nutmeg.  The  cells  of  the  liver  are 
infiltrated  and  filled  with  globules  of  fat,  colored  with  brownish  pigment, 
in  the  shape  of  granulated  clots.  The  cadaver  is  generally  anaemic;  the 
Ijlood  is  clotted  in  the  heart  and  large  blood  vessels  or  we  find  large 
lumps  of  hard  reddish-yellow  coagulate,  or  the  blood  may  be  stained 
yellow  and  contain  white  blood  corpuscles  in  increased  quantities.  The 
red  blood  corpuscles  are  not  much  changed,  but  vary  in  size.  All  the 
tissues  of  the  body,  except  the  white  substance  of  the  brain,  the  spinal 
cord,  the  peripheral  nerves  and  the  corneal  tissue,  are  stained  more  or  less 
by  the  bile-pigment.  The  heart  muscle  undergoes  a  certain  amount  of 
fatty  degeneration.  The  kidneys  are  anaemic;  in  the  pale  portion  of  the 
kidney  we  see  extensive  whitish  stripes  running  in  the  direction  of  the 
urinary  canals;  this  is  caused  by  an  irregular  fatty  degeneration  and 
pigmentary  infiltration  of  the  canals  (Siedamgrotsky). 

Clinical  Symptoms  and  Course  of  the  Disease. — As  this  disease  is 
generally  associated  with  catarrh  of  the  stomach,  the  first  symptoms  in 
jaundice  will  be  of  that  disease — loss  of  appetite,  increased  thirst,  vomit- 
ing, coated  tongue;  in  some  rare  instances,  however,  these  may  be  absent, 
the  first  symptom  being  that  of  jaundice  (yellowishness  of  the  mucous 
membranes) . 

When  the  bile  and  liile  acids  enter  the  blood  the  following  symptoms 
are  observed: 

1 .  By  the  entrance  of  the  coloring  matter  of  the  bile  into  the  tissues, 
they  become  more  or  less  yellow,  first  yellowishness  of  the  conjunctiva 


106  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

and  sclerotic  coat;  later  the  whole  cutaneous  covering  becomes  tinted. 
The  yellowishncss  may  be  very  plainly  seen  on  the  abdomen,  on  the  inner 
fascia  of  the  thighs,  and  the  mucous  membrane  of  the  mouth  and  throat; 
the  color  may  range  from  a  light  yellow  to  a  dirty  orange-yellow;  the 
latter  color  generally  spreads  over  the  entire  body  in  the  later  stages  of 
the  disease. 

2.  On  account  of  the  coloring  matter  being  present  in  the  urine,  it  is 
changed  from  the  normal  to  a  yellowish-green  or  to  a  dark  greenish  color; 
wdien  put  in  a  vessel  and  agitated  it  foams  very  quickly  and  if  a  piece  of 
paper  or  linen  is  placed  in  it,  it  becomes  tinted  the  color  of  the  bile.  It 
is  also  easy  to  detect  the  presence  of  bile  color  of  the  urine  by  chemical 
examination.  (For  further  details,  see  the  chapter  on  the  Examination 
of  the  Urinary  Apparatus.)  Besides  the  bile  acids,  the  urine  almost 
always  contains  albumen,  short  hyaline  casts,  pigment  granulations,  and 
epithelium  of  the  kidney. 

3.  On  account  of  the  stoppage  of  the  flow  of  bile  into  the  intestines, 
the  faeces  become  gray  or  clay-colored  and  contain  much  undigested  fat, 
and  hydrobilirubin  is  present.  The  fat  substances  not  being  digested, 
the  fseces  become  very  foetid;  this  change  is  due  to  the  loss  of  the  antiseptic 
effect  of  the  bile,  and  as  the  food  is  passed  along  the  intestine  the  tonic 
effect  of  the  bile  is  absent. 

4.  The  bile  acids  present  in  the  blood  produce  a  certain  amount  of 
depression  of  the  nerve-centres,  and  for  this  reason  we  find  that  the  pulse 
and  respiration  are  subnormal  in  action,  and  the  temperature  is  reduced. 
Other  symptoms  of  the  narcotic  effect  of  the  bile  are  seen  in  some  cases 
■where  there  is  depression,  great  muscular  debility,  indifference  to  sur- 
roundings, somnolence  and  finally  deep  coma;  we  also  find  hemorrhagic 
conditions  of  the  skin  or  mucous  membrane. 

The  local  examination  of  the  liver  gives  very,  little  satisfaction. 
The  writer  has  never  been  able,  except  in  one  case,  to  find  any  percep- 
tible enlargement  of  the  liver.  Manipulation  of  the  liver  does  not  seem 
to  give  the  animals  pain  in  the  later  stages  of  the  disease.  The  prog- 
nosis in  the  dog  is  generally  unfavoral^le.  The  yellow  coloration  gradu- 
ally becomes  deeper,  the  temperature  falls  to  subnormal  in  the  majority 
of  cases,  the  pulse  becomes  weak  and  irregular,  and  finally  death  occurs  with 
general  paralysis.  If  the  cases  progress  favorably,  the  first  sign  is  a 
lessening  of  the  coloration  of  the  urine  and  a  darker  hue  to  the  fseces; 
the  pulse  becomes  fuller  and  more  regular,  the  temperature  increases, 
the  animal  shows  more  animation,  and  the  color  in  the  mucous  membrane 
and  the  skin  becomes  lighter,  until  it  finally  disappears.  If  there  is  a 
relapse,  it  is  generally  by  improper  feeding. 

Therapeutics. — ^^'e  must  first  aim  to  reduce  the  irritation  of  the 
duodenum    also  the  bile-ducts.     This  is  first  effected  by  regulating  the 


OTHER  AFFECTIONS  OF  THE  LIVER  107 

diet;  small  quantities  of  lean  meat,  milk,  purees,  gruel,  and  besides  this 
giving  saline  laxatives  and  alkaline  in  the  form  of  carbonates  and  car- 
bonic acid,  if  the  constipation  is  persistent.  Strong  purgatives  have 
been  recommended,  such  as  calomel,  castor  oil,  and  infusions  of  rhubarb; 
but  they  are  of  no  particular  value;  in  fact,  in  the  majority  of  cases,  they 
do  more  harm  than  good,  as  they  have  a  tendenc}'  to  swell  the  mucous 
membrane.  Enemas  of  warm  water,  two  or  three  times  daily  are  very 
useful.  "We  can  also  try  to  empty  the  gall  bladder  mechanically,  by 
pressing  the  al^domen  between  the  fingers  in  the  region  of  the  kidneys; 
also  by  faradization — a  strong  current  is  to  be  applied  in  the  region  of  the 
liver  on  both  sides  of  the  abdomen;  this  must  be  kept  up  for  ten  minutes 
at  a  time,  twice  daily.  Or  we  may  use  emetics,  it  being  claimed  that  the 
compression  of  the  liver  during  emesis,  the  violent  contraction  of  the 
abdomen,  will  often  empty  the  gall  bladder.  We  can  also  try  to  carry 
the  bile  out  of  the  system  by  the  kidneys.  The  best  drugs  to  use  are 
diuretics,  such  as  acetate  of  sodium  or  potassium.  Where  there  is  great 
debility  or  depression  we  can  use  spirits  of  camphor  or  ether.  Boldine, 
the  alkaloid  of  the  Pennus  boldos,  hasrecently  been  spoken  of  as  producing 
good  results  in  jaundice;  it  is  given  in  doses  of  0.08  gramme  daily  with 
calomel.  Great  weakness  or  persistent  sleepiness  can  be  treated  with 
camphor,  ether,  and  caffeine. 

I^.     Sal.  CaroHn  fact.  10.0 

Aqua,  150.0 

M.  F,  Sig. — One  tablespoouful  three  times  daily. 

I^'.     Sodii  salicylatis,  4  to  10.0 

Syrupi  Rhei,  200.0 

M.  F.  Sig. — One  tablespoonful  morning  and  night. 

I^.     Ac.  Tartaric,  15.0 

Aqua  distilata,  200.0 

M.  F.  Sig. — One  teaspoonful  three  times  daily. 

Other  Affections  of  the  Liver. 

The  other  affections  of  the  liver  are  of  slight  importance  and  are 
rarely  met  with  during  life,  consequently  they  will  be  only  mentioned 
briefly. 

Hyperaemia  of  the  Liver. — This  may  be  caused  either  by  an  increased 
or  obstructed  flow  of  the  bile,  and  therefore  it  is  important  to  be  able 
to  distinguish  between  the  two. 

Congestive  hyperemia  of  the  liver  is  a  normal  condition  during 
digestion;  it  may  be  abnormally  increased  by  eating  large  quantities 
of  food,  especially  if  it  is  rich  and  irritating,  and  from  want  of  exer- 
cise; decayed  or  tainted  food  may  also  cause  this  condition. 


108  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

Stagnating  hypcripmia  of  the  liver  may  be  caused  by  defective 
valvular  action  of  the  heart  or  a  weakened  condition  of  that  organ; 
in  the  later  stages  of  acute  diseases,  such  as  the  lungs;  in  cases  where 
large  numbers  of  the  lung  capillaries  become  atrophied  and  useless;  in 
great  pleuritic  exudations;  in  extensive  induration  of  the  lungs,  with 
emphysema;  and  also  in  dropsy  of  the  pericardium. 

Pathological  Anatomy. — The  liver  is  greatly  enlarged  and  very  hard; 
when  a  section  is  cut  in  it,  the  blood  seems  to  run  out  of  it  in  large  quanti- 
ties. This  blood  generally  is  dark  colored,  especially  if  the  stagnation 
has  been  prolonged.  The  liver  tissue  may  be  spotted,  the  spots  cor- 
responding with  the  central  veins  which  are  located  in  the  centre  of  the 
lobules;  or  we  may  notice  peripheric  zones  (nutmeg  liver)  alternating 
with  lighter  colored  spaces.  The  liver  gradually  becomes  smaller  and  its 
surface  dull,  and  later  on  the  parenchyma  finely  granular. 

Clinical  Symptoms. — It  is  not  possible  to  make  a  positive  diagnosis 
of  this  disease,  we  can  only  suspect  it  by  great  tenderness  on  pres- 
sure in  the  region  of  the  liver,  and  perhaps  slight  icterus,  ascites  may 
accompany  hyperaemia  of  the  liver;  but  as  these  symptoms  may  all  be 
caused  by  catarrh  of  the  bowels,  it  is  well  to  be  very  cautious  before 
making  a  positive  diagnosis. 

Therapeutics. — Remove  the  cause  if  possible,  regulate  the  diet  and 
administer  saline  laxatives. 

Inflammation  of  the  Liver  (Hepatitis). — This  disease  appears  in 
three  forms — parenchymatous,  interstitial  and  purulent. 

1.  Parenchymatous  hepatitis  accompanies  various  infectious  dis- 
eases, probably  in  the  same  way  that  we  see  congestion  of  the  liver. 
It  is  seen  as  a  symptom  of  acute  phosphorus-poisoning,  also  as  an  ac- 
companiment of  certain  infectious  diseases. 

The  pathological-anatomical  alterations  are  as  follows:  Enlarge- 
ment, softening,  and  a  friable  condition  of  the  tissue,  which  breaks 
easily  to  the  touch.  At  first  it  is  dark  red,  but  later  on  it  becomes  a 
yellowish  clay  color,  due  to  the  enlarged  acini;  the  capsule  is  dull  and 
thickened,  due  to  a  certain  amount  of  perihepatitis.  If  the  disease 
lasts  any  time,  the  volume  of  the  liver  is  greatly  lessened. 

The  clinical  symptoms  are,  evidences  of  catarrh  of  the  stomach, 
pain  on  pressure  in  the  region  of  the  liver,  icterus,  and  the  liver  is  found 
on  palpation  to  be  enlarged. 

2.  Interstitial  Hepatitis  (Cirrhosis  of  the  Liver)  (Hardening  of 
the  Liver). — This  disease  originates  from  causes  that  are  at  present  un- 
known. There  is  no  doubt  that  certain  chemical  or  bacterial  poisons 
which  originate  in  the  intestines  have  some  part  in  causing  this  disease. 
Friedberger  and  Frohner  surmise  that  it  is  caused  by  valvular  disease 
of  the  heart. 


OTHER  AFFECTIONS  OF  THE  LIVER  109 

Pathological  Anatomy. — There  are  two  stages  in  this  disease.  In 
the  first  stage  the  liver  is  very  much  enlarged  and  hard,  the  edges  of 
the  lobes  are  blunt  on  the  surface,  there  are  a  number  of  uneven  de- 
pressions. On  making  a  transverse  section,  we  find  a  net-work  of  red- 
dish-gray tissues  that  surround  the  lobules;  later  on  this  involves  the 
lobules  themselves.  In  the  second  stage  we  find  a  cicatricial  contraction, 
of  newly  formed  tissue,  and  at  the  same  time  the  disappearance  of  the  true 
tissue  of  the  liver.  The  liver  then  becomes  gradvuilly  smaller  and  has 
a  very  irregular  surface;  the  capsule  is  thickened  and  in  some  places  de- 
pressed; the  tissue  is  hard  and  tough  when  cut  with  a  knife. 

Clinical  Symptoms. — The  disease  generally  starts  withovit  any 
visible  symptoms,  although  it  is  a  common  disease  in  old  dogs  that  have 
lived  well.  When  the  disease  has  become  pretty  well  advanced  we  find 
evidences  of  an  interference  in  the  portal  circulation  by  the  appearance 
of  ascites  and  chronic  catarrh  of  the  stomach.  "With  these  symptoms 
we  also  find  a  tendency  to  constipation  with  occasional  changes  to  diar- 
rhoea. In  rare  instances  a  certain  amount  of  icterus  is  present.  This 
is  due  either  to  the  interference  with  the  passage  of  the  bile  from  the 
gall  bladder  by  catarrh  of  the  duodenum  or  to  a  contracted  condi- 
tion of  the  small  bile-ducts.  There  is  no  pain  on  pressure  in  the  region 
of  the  liver,  even  in  the  advanced  stages  of  the  disease.  After  removing 
the  fluid,  the  outline  of  the  liver  can  be  felt  by  palpation. 

The  disease  is  generally  very  slow,  but  ends  fatally;  when  there  is 
ascites  and  some  oedema  of  the  extremities  present,  the  end  is  not  far 
off. 

Therapeutics. — This  consists  in  treating  the  case  as  if  it  were  one  of 
catarrh  of  the  stomach,  by  means  of  saline  purgatives  and,  if  ascites  is 
present,  by  puncture.     The  disease  should  be  regarded  as  incurable. 

3.  Purulent  Inflammation  of  the  Liver  (Abscess  of  the  Liver). — 
This  may  be  caused  by  injuries,  such  as  blows  or  kicks,  externally,  or 
from  foreign  bodies  or  perforating  abscesses  coming  from  the  stomach, 
from  metastasis  from  phlebitis  and  thrombus  undergoing  purulent  de- 
struction, and  from  pyemia  in  abscess  of  the  stomach,  and  in  the  bile- 
ducts  from  the  presence  of  gall-stones  or  parasites. 

Pathological  Anatomy. — Abscesses  of  the  liver  appear  singly  but 
may  be  present  in  large  numbers;  the  traumatic  abscess  is  generally 
solitary  and  the  metastatic,  multiple.  The  pus  is  cream-like  and  in 
some  instances  foetid  and  reddish-green  in  color.  Small  abscesses  may 
heal  by  absorption,  but  the  large  ones  open  into  the  abdominal  cavity 
and  cause  fatal  peritonitis. 

Icterus  symptoms,  with  frequent  chills,  point  to  abscess  of  the 
liver.     Treatment  is  useless. 

Fatty  Liver   (Hepar  Adiposum). — This  is  an  abnormal  diffuse  fatty 


110  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

infiltration  of  the  cells  of  the  liver.  It  is  hard  and  seems  anaemic  when  the 
section  is  made  through  the  organ.  The  cells  are  found  to  be  infiltrated 
with  fatty  globules  and  the  nuclei  pushed  to  one  side. 

This  condition  is  seen  in  old  dogs  that  have  been  well  fed  and  had 
little  exercise,  and  is  naturally  a  fatty  infiltration.  It  must,  however, 
be  distinguished  from  the  fatty  degeneration  that  is  found  to  follow  sev- 
eral poisons,  and  in  the  later  stages  of  consumption.  In  fatty  infiltration 
the  blood  of  the  portal  vein  carries  abnormal  quantities  of  fat  into  the 
liver,  which  is  deposited  in  the  cells.  In  fatty  degeneration  the  fat 
originates  in  the  cells  themselves;  this  is  due  to  the  albumin  separating 
into  two  substances.  One  contains  nitrogen,  while  in  the  other  it  is 
absent.     This  latter  part  undergoes  fatty  degeneration. 

The  treatment  of  fatty  liver  is  the  same  as  for  any  adipose  condition. 

Neoformations  of  the  Liver  and  Gall-stones. — The  neoformations 
found  in  the  liver  of  the  dog  are  sarcomas,  carcinoma,  adenoma,  and  lip- 
oma. These  cause  irregular  enlargements  on  the  body  of  the  liver,  and 
produce  symptoms  similar  to  those  of  cirrhosis  of  the  liver.  Some- 
times large  tumors  can  be  felt  through  the  abdominal  wall. 

Gall-stones  are  very  rare  in  the  dog.  Frohner  describes  one  case 
where  the  animal  died  with  an  icterus  gravel.  Immediately  after  death 
he  found  in  the  ductus  choledochus  a  large  bluish-black  friable  gall 
stone,  the  size  of  a  pea.  On  section,  this  was  brownish-yellow  in  the 
centre.  Parascendolo  described  one  case  where  the  ductus  choledochus 
was  impacted  with  a  mass  of  stones.  The  only  way  that  they  might 
be  recognized  would  be  the  appearance  of  icterus,  from  retention,  pre- 
ceded by  intense  colic. 

Treatment  is  the  same  as  retention  icterus;  small  gall  stones  may 
be  present  in  the  gall  bladder  without  causing  any  peculiar  symptoms, 
other  than  slight  disturbance  of  the  digestion. 

Parasites. — The  following  parasites  have  been  found  in  the  liver: 
distoma  truncatum,  distoma  campanulatum,  and  distoma  conjunc- 
tum  (Ercolani).  In  the  bile-ducts,  ascarides  have  been  found,  Ercolani 
and  Lissizin  found  a  fully  developed  male  eustrongylus  gigas  and  coccidia 
(Rivolta),  also   the  l)ladder  cyst  of  the  echinococcus. 

Amyloid  and  Lardaceous  Liver. — Amyloid  liver,  as  a  rule,  is  a 
symptom  of  a  general  amyloid  condition,  developed  from  a  cachectic 
state,  from  prolonged  suppurating  wounds  or  from  chronic  inflammation 
of  the  pectoral  membranes. 

The  liver  is  very  much  enlarged  and  blunt  on  the  edges  of  the  lolies. 
On  section,  the  cut  surface  is  speckled  and  grayish-brown  in  color.  On 
microscopical  examination  the  walls  of  the  capillaries  will  be  found  to  have 
undergone  amyloid  degeneration;  when  stained  with  Lugol's  iodine  solu- 
tion, the  degenerated  portions  become  mahogany-brown  in  color. 


POISONS  111 

Lardaceous  liver  is  developed  when  we  have  a  disease  that  has  a 
tendency  to  produce  amyloid  degeneration.  The  liver  becomes  very 
large.  With  it  we  generally  find  amyloid  kidney  with  albumin  in  the 
urine  and  we  also  are  apt  to  find  an  amyloid  spleen. 

POISONS. 

A  short  abstract  on  poisons  with  their  symptoms  and  treatment 
is  here  given;  it  is  not  at  all  complete,  and  the  student  is  referred  to  works 
on  toxicology. 

Poisoning  by  Caustic  Alkalies. — Caustic  lime,  soda  or  potassium, 
lye,  sal.  ammoniac,  etc.  These  in  their  concentrated  form  may  be  ad- 
ministered accidentally,  or  may  have  been  used  in  some  external  prep- 
aration and  licked  off  by  the  animal.  Caustic  soda  or  potassium  may 
be  sw^allowed  by  animals  that  are  very  thirsty.  The  writer  observed  a 
dog  that  was  poisoned  eating  meat  that  had  caustic  lime  sprinkled  on  it. 

The  lips,  mouth,  tongue,  throat,  and  oesophagus  are  more  or  less 
cauterized,  with  salivation  and  vomiting  of  strongly  alkaline  materials, 
which  is  sometimes  bloody.  There  is  bloody  diarrhoea.  The  potas- 
sium preparations  cause  paralysis  of  the  heart. 

The  treatment  consists  in  the  administration  of  vinegar  or  acetic 
acid,  gruels  of  flour,  oat  meal,  starch,  emulsions  of  oil  (olive,  linseed,  or 
cotton-seed).  The  giving  of  emetics  or  the  use  of  the  stomach  pump 
is  contra-indicated,  as  they  are  apt  to  cause  perforation  of  the  stomach. 

Poisoning  by  Caustic  Acids. — This  is  of  rare  occurrence  and  is  gen- 
erally caused  by  the  insufficient  dilution  of  medicinal  preparations,  or 
the  vicious  administration  of  acids. 

The  mucous  membrane  of  the  mouth,  throat,  and  cesophagus,  is 
eroded  or  burnt  brown.  There  is  salivation  and  vomiting  of  a  brownish- 
black  material,  with  a  strong  acid  reaction,  which  contains  more  or  less 
blood,  violent  pain,  small  thready  pulse,  and  finally  collapse. 

Therapeutics. — Emetics  and  the  stomach  pump  are  contra-indicated, 
as  there  is  danger  of  perforation,  Limewater,  dilute  ammonia  or 
soda  solutions,  emulsions  of  olive,  linseed,  or  cotton-seed  oils,  small  c{uan- 
tities  of  opium,  and  in  case  of  collapse  the  subcutaneous  injection  of 
ether  or  camphor. 

Poisoning  by  Arsenic. — This  is  sometimes  given  intentionally  on 
pieces  of  meat,  or  caused  by  eating  some  of  the  various  rat  poisons,  the 
overdosing  of  Fowler's  solution,  or  licking  external  preparations  that 
contain  arsenic. 

There  is  violent  inflammation  of  the  stomach  and  intestines,  great 
restlessness,  bloody  diarrhoea,  vomiting  and  dyspnoea,  great  weakness, 
and  finally  collapse  and   death  in  a  few  hours. 


112  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

Therapeutics. — Emetics  and  iron  preparations,  the  hydrated  ses- 
quioxide  of  iron  every  quarter  of  an  hour,  carbonate  of  magnesia,  a 
teaspoonful  every  twenty  minutes,  followed  by  alcoholic  stimulants. 
The  stomach  pump  can  be  used,  if  there  is  not  prompt  emesis. 

Poisoning  by  Hydrocyanic  Acid;  Prussic  Acid. — This  is  generally 
given  intentional}}',  in  the  foi'm  of  cyanide  of  potassium,  rarely  the  pure 
acid.  There  is  an  odor  of  bitter  almonds  on  the  breath.  The  symp- 
toms are  vomiting,  yelping  cries,  dyspnoea,  convulsions  of  the  legs,  and 
death  in  a  short  time.  If  the  dose  should  be  small,  there  is  restlessness, 
fear,  dyspnoea,  dilated  pupils,  convulsions  of  the  extremities,  fall  in  tem- 
perature until  it  is  subnormal,  marked  slowness  of  the  respirations  and 
pulse,  cyanosis  and  unconsciousness. 

Therapeutics. — Emetics,  artificial  respiration  (rhythmic  pressure 
of  the  lower  abdominal  walls,  bathing  in  cold  water,  stimulants,  chlo- 
rine  water,    and   subcutaneous   injections   of   atropia. 

Poisoning  by  Carbolic  Acid. — This  is  quite  frequently  observed 
and  is  caused  by  the  animal  licking  external  preparations  which  con- 
tain the  drug;  this  is  frequently  seen  as  a  result  of  the  use  of  some  of  the 
various  preparations  sold  under  the  name  of  creolin,  which  are  nothing 
more  than  crude  carbolic  acid,  or  some  coal  tar  by-product,  and 
the  animal  is  bathed  frequently  in  a  strong  solution  of  it.  It  may 
also  be  caused  by  the  animal  licking  a  wound  or  the  wound  absorbing 
carbolic  acid,  tar  or  creosote  which  has  been  applied  as  a  dressing.  It 
may  also  he  absorbed  following  the  injection  of  strong  solutions  of  carbolic 
acid  into  the  uterus.  The  urine  is  dark  in  color,  frequently  a  dark  olive 
green,  there  is  slight  colic,  pain  on  pressure  of  the  abdomen,  vomiting, 
diarrhoea,  great  inflammation  and  redness  of  the  mouth,  marked  weakness, 
decrease  in  the  temperature,  twitching  of  the  muscles,  paralysis,  con- 
vulsions and  collapse. 

Treatment. — White  of  egg,  glaubcr  salts,  and  stimulants. 

Poisoning  by  Iodoform. — This  may  be  caused  by  licking  wounds 
dressed  with  the  drug  and  also  from  the  injections  into  cysts  of  too 
strong  solutions.  In  very  large  doses  we  find  great  gastric  disturbance, 
small,  frequent  pulse,  decrease  in  the  internal  temperature,  suppression 
of  urine,  albuminuria,  dulncss,  and  convulsions,  alternated  with  great 
excitement  and  finally  collapse.  In  smaller  doses  we  find  catarrh  of 
the  mucous  membranes,  emaciation,  and  skin  eruptions. 

Therapeutics. — In  the  acute  form  give  emetics  followed  by  carbonate 
of  potash,  large  quantities  of  starch,  subcutaneous  injections  of  atropia. 
In  the  milder  forms  saline  laxatives,  tonics  and,  of  course,  immediately 
remove  the  cause. 

Poisoning  by  Phosphorus. — This  may  be  caused  by  the  animal  eating 
some  of  the  various  roach  or  bug  poisons  that  have  been  spread  on  bread 


POISOXS  113 

and  placed  in  a  cellar  or  liuilding.  There  is  constant  vomiting,  the  odor  of 
the  ejected  matter  is  that  of  phosphorus,  and  if  taken  into  a  dark  room 
it  is  luminous. 

There  is  great  restlessness,  howling,  whining,  fever,  and  indications  of 
intense  irritation  of  the  mouth  and  throat;  and  the  saliva  is  thick  and 
copious.  After  these  symptoms  have  been  present  for  some  time,  the 
animal  becomes  quiet,  the  mucous  membranes  become  dirty  yellow, 
great  pain  on  pressure  on  the  liver,  stomach,  and  intestines.  The  faces 
are  tinged  with  blood  and  there  is  albuminuria;  and  according  to  some 
authors,  if  there  is  any  icterus  in  a  suspected  case,  it  is  a  clear  indication  of 
phosphorus  poisoning;  finally,  there  is  paralysis  and  collapse. 

Therapeutics. — Use  sulphate  of  copper  as  an  emetic,  and  turpentine 
in  emulsion  as  an  antidote,  and  treat  other  symptoms  as  they  appear. 
Permanganate  of  potash,  nitrate  of  cobalt,  heavy  magnesia,  are  antidotes. 

I^.     Cupri  Sulphatis,  1.0 

Aquae  distillatse,  .50 . 0 

Sig. — Give  a  teaspoonful  every  ten  minutes  until  eme- 
sis  occurs. 

I^      01.  Terebinthinse,  20.0 

Sol.  Acacia,  50.0 

Aqua.  Distil.,  200.0 
Sig. — A  tablespoonful  every  fifteen  minutes. 

Poisoning  by  Mercury. — 1.  Acute  poisoning  by  corrosive  sublimate  is 
very  rare.  The  symptoms  are  intense  inflammation  of  the  entire  intesti- 
nal tract,  vomiting  of  blood  and  bloody  diarrhoea,  with  intense  local  irri- 
tation followed  by  symptoms  of  paralysis  and  death. 

2.  Mercurial  Poisoning  takes  a  slower  course  when  caused  by  calomel 
or  mercurial  dressings,  particularly  w'hen  mercurial  (blue)  ointment  is 
applied  for  skin  eruptions.  We  find  salivation,  catarrh  of  the  stomach, 
profuse  diarrhoea,  emaciation,  with  marked  muscular  debility. 

Therapeutics. — In  the  acute  form  give  gruels,  milk,  magnesia,  water, 
sulphur,  iodide  of  potassium,  stimulants.  In  the  slower  form  of  poisoning 
give  iodide  of  potassium,  or  sulphur. 

Poisoning  by  Strychnia. — This  is  frequently  administered  intention- 
ally, although  it  is  often  caused  by  the  administration  of  too  large  doses  of 
nux  vomica,  dogs  being  particularly  susceptible  to  the  action  of  strychnia. 
There  are  violent  tetanic  spasms,  trismus,  and  opisthotonus.  The  convul- 
sions are  clonic,  having  intermissions  between  them,  and  the  longer  the 
intermission  the  milder  the  attack  and  the  more  chance  of  a  recovery. 

Therapeutics. — Give  narcotics,  chloral  hydrate  in  clysters,  2.5 
grammes  to  40.0  of  water;  morphia,  tannin,  and  tincture  of  iodine. 

Poisoning  by  Chloroform. — This  is  caused  either  by  the  careless  ad- 
8 


114  DISEASES  OF  THE  DIGESTIVE  APPARATUS 

ministration  of  chloroform  during  anaesthesia,  or  when  animals  are  old  or 
have  weak  hearts  or  lungs.  It  destroys  sensibility,  reflex  action,  ir- 
regular, weak  pulse,  dilated  pupil,  the  blood  becomes  very  dark  and  there 
is  congestion  and  cyanosis  of  the  visible  mucous  membranes,  arrest  of 
respiration  and  pulsation. 

Therapeutics. — Cease  the  inhalation  immediately,  put  the  animal  in 
the  fresh  air,  open  the  mouth,  draw  out  the  tongue  by  means  of  a  pair 
of  forceps,  and  perform  artificial  respiration.  Dash  cold  water  on  the 
head,  active  friction  of  the  skin,  and  the  subcutaneous  injection  of 
atropia,  skopolamin,  or  strychnia. 

ly.     Atropia  sulph,  0.05 

Aqua  distil.,  5.0 

Sig. — Inject  a  gramme  of  the  solution  subcutaneously. 

Poisoning  with  Gas  (Coal,  Carbondioxide,  or  Illuminating). — Great 
lassitude,  insensibility,  labored  respiration,  mydriasis,  paralysis,  and 
convulsions. 

Therapeutics. — Fresh  air,  artificial  respiration,  dash  cold  water  on 
the  head,  active  friction  of  the  skin,  smelling  salts,  bleeding,  and  the  in- 
travenous injection  of  the  physiological  solution  of  chloride  of  sodium. 

Poisoning  by  Iodine. — This  may  residt  from  the  licking  or  the  absorp- 
tion of  iodine,  particularly  when  it  is  used  in  the  injection  of  cysts  in  the 
form  of  iodine  or  Lugol's  solution. 

The  symptoms  and  course  are  very  similar  to  iodoform.  After  a 
toxic  dose  there  is  stomatitis  and  pharyngitis,  brown  patches  on  the  tongue 
and  the  vomiting  of  l)rown  material,  and  if  starch  should  be  present  in  the 
stomach  in  any  (quantity,  the  material  is  turned  bluish  in  color.  The  free 
administration  of  starch  solution,  and  sulphate  of  soda  and  sulphurette  of 
soda  in  solution  1  to  20  of  water,  must  be  given  freely  in  teaspoonful  doses. 


DISEASES  OF  THE  RESPIRATORY  ORGANS. 

PHYSICAL  EXAMINATION  OF  THE  RESPIRATORY  APPARATUS. 


In  making  an  examination  of  the  respiratory  apparatus  the  following 
points  are  to  be  considered: 

Examination  of  the  Nose. 


It  is  a  rather  hard  thing  to  make  an  examination  of  the  nose,  on  ac- 
count of  the  anatomical  conformation  of  that  part,  and  we  are  practically 
restricted  to  the  aid  a  nasal  mirror  can  give  us  and  the  character  of  the 
nasal  secretions.  The  external  portion  of  the  nose  is  moist  and  cold  in 
health,  colder  than  any  other  part  of  the  body,  and  dry  and  w^arm  when 
a  dog  has  any  fever  or  elevation  of  temperature,  in  the  first  stages  of  nasal 
catarrh,  and  in  fevers  or  acute  disease.  This  should  not  be  taken  as  a 
positive  evidence,  as  frecjuently  cases  are  seen  where  this  is  no  guide,  the 
nose  being  cold  when  there  is  great  fever  or  the  animal  in  a  state  of 
collapse. 

Swelling,  redness,  and  excoriation  at  the  entrance  of  the  nasal  cham- 
bers indicate  an  inflammatory  and  purulent  condition  of  the  nasal  mucous 
membrane. 

Any  discharge  from  the  nose,  beyond  a  natural  moistness,  indicates 
some  diseased  condition.  In  cases  of  acute  nasal  catarrh  it  is  clear  and 
thin,  nearly  pure  serum  in  the  beginning,  but  later  on  it  becomes  mucous 
and  finally  muco-purulent.  In  chronic  catarrh  it  is  firmer,  sticky,  and 
finally  very  tenacious,  and  sticks  to  the  external  opening  of  the  nose, 
often  entirely  closing  it  up  and  eroding  the  skin,  where  it  comes  in  contact 
with  it.  In  distemper  it  is  yellowish  to  yellowish-green  in  color;  some- 
times it  is  streaked  with  blood  or  pus,  and  in  rare  cases  it  has  a  foetid  odor. 

When  the  discharge  is  copious,  especially  when  the  head  is  jerked 
downward  with  a  sneezing  cough,  it  is  generally  a  sign  of  some  irritation  of 
the  frontal  sinuses.  A  nasal  discharge  following  coughing  generally  comes 
from  some  trouble  in  the  deep  sections  of  the  air-passages,  larynx,  wind- 
pipe, bronchi,  or  the  lungs;  a  rusty  yellow  discharge  indicates  croupous 
pneumonia;  this  is,  however,  very  rare.  Frequent  sneezing,  with  a 
copious,  purulent,  bad-smelling  discharge  mixed  with  blood  points  to  the 
presence  of  pentastoma  taenioides  in  the  frontal  or  nasal  cavities.  In  cases 
of  acute  catarrh  of  the  throat,  foreign  bodies,  paralysis  of  the  larynx,  or 

115 


116 


DISEASES  OF  THE  RESPIRATORY  ORGANS 


large  tumors  in  the  throat,  the  discharge  from  the  nose  may  be  mixed  with 
some  of  the  contents  of  the  stomach.  These  affections  are  extremely  rare 
in  the  dog  compared  with  other  animals.  True  cases  of  bleeding  of  the 
nose  are  seen  in  hemorrhagic  catarrh  of  that  organ,  in  suppurating  con- 
ditions of  the  nasal  cavities  from  the  pentastome,  and  also  in  distemper. 
Hemorrhage  of  the  lungs  is  indicated  when  there  are  large  masses  of 
frothy  blood  discharged  from  the  nose  and  mouth.  Wheezy  respiration  is 
generally  due  to  some  contraction  of  the  nasal  cavities,  for  instance,  as  a 
consequence  of  violent  nasal  catarrh,  tumors,  fractures  of  the  nasal  bones, 
narrowing  of  the  nasal  passages,  pressure  from  some  of  the  neighboring 
organs,  or  solid  collections  of  matter.  In  some  breeds  of  dogs,  such  as 
pugs  and  bulldogs,  the  passage  is  so  narrow  that  a  slight  contraction  may 
cause  them  to  breathe  through  the  mouth.  A  simple  method  of  detecting 
whether  the  nostril  is  entirely  obstructed  is  to  hold  a  lighted  candle  in 


Fig.  53. — Diagrammatic  section  of  the  pharynx:  a,  pharynx;  b,  palate;  c,  soft  palate;  d,  epiglottic 
wall;  e,  fnpnum;  /,  entrance  to  wsophagus;  /;,  entrance  to  the  mouth  i,  entrance  to  the  Eustachian  tube; 
k,  entrance  to  the  nasal  passages;  1,  epiglottis;  2,  larynx;  3,  cavity  of  the  mouth;  4,  epiglottis;  5,  aryte- 
noid cartilage;  6,  palate;  7,  vomer;  8,  base  of  skull. 

front  of  the  nostril  suspected  and  see  if  the  flame  is  blown.  If  the  nostril 
is  clear  the  flame  moves  violently  or  may  be  blown  out,  but  if  the  obstruc- 
tion is  complete  or  partial  the  flame  moves  slightly  or  not  at  all.  The 
nasal  sound  is  like  a  snore  when  copious  accumulations  of  mucus  have 
collected  on  the  mucous  membrane,  as  in  distemper,  or  the  later  stages  of 
simple  catarrh  of  the  nose.  In  all  the  affections  named,  many  animals 
seem  to  have  an  intense  itching,  which  they  indicate  by  rubbing  the  nose 
against  solid  objects,  or  wiping  it  with  the  paws.  We  must  recollect, 
however,  that  the  same  symptoms  may  be  observed  in  an  animal  infected 
W'ith  intestinal  worms. 

The  naso-pharyngeal  region  can  be  examined  by  means  of  the  laryn- 
geal mirror;  when  the  presence  of  foreign  bodies  or  pathological  process, 
tumors,  etc.,  is  suspected,  the  mouth  is  held  open  by  means  of  a  speculum 
and  the  mirror  introduced  into  the  mouth;  this  method  of  examination 
should  be  made  as  quickly  as  possible  as  the  instrument  chokes  the  ani- 


PHYSICAL  DIAGNOSIS  OF  THE  LARYNX  117 

mal;  the  observer  must  act  quickly  and  have  a  thorough  understanding  of 
the  region  and  any  pathological  symptoms  noted. 

Percussion  of  the  nose  and  frontal  sinuse  is  made  with  some  light 
metal  hammer  such  as  the  handle  end  of  a  key,  percussing  first  one  nasal 
bone  and  over  the  frontal  sinuses,  then  the  other,  to  note  the  difference  in 
sound.    A  dull  sound  may  indicate  a  catarrhal  condition  of  the  nostril,  or 


Fig.  54. — Position  of  the  frontal  sinuses  a,  inferior;  b,  superior. 

frontal  sinuses,  the  presence  of  a  tumor,  or  some  pathological  alterations; 
on  the  other  hand,  the  presence  of  a  clear  percussing  sound  should  not  be 
taken  as  indicating  that  these  changes  are  not  present.  Large  tumors  by 
pressure  cause  changes  or  elevations  on  the  nasal  bones  of  the  frontal 
sinuses;  such  alterations  may  also  be  seen  in  the  hard  palate  see  (Fig.  54). 

Physical  Diagnosis  of  the  Larynx  and  Windpipe. 

The  symptoms  include  the  bark,  cough,  and  respiration,  as  well  as  the 
local  symptoms.  The  bark  is  always  rough,  hoarse,  or  shrill  in  all  affec- 
tions of  the  internal  larynx,  and  is  always  of  great  importance  in  rabies 
(barking  howl),  or  total  loss  of  voice;  this  is  particularly  seen  during  or 
after  dog  shows.     The  cough  is  an  accompaniment  of  all  affections  of  the 


118  DISEASES  OF  THE  RESPIRATORY  ORGANS 

larynx;  and  in  the  later  stages  of  catarrh,  where  there  is  much  mucus, 
it  is  loose,  moist,  and  rattling,  and  may  be  produced  by  slight  pressure  on 
either  side  of  the  larynx,  by  cold,  pressure,  or  after  drinking;  in  any  chronic 
irritation  of  the  larynx,  any  excitement,  such  as  the  pleasure  of  meeting  a 
person  they  know,  will  start  a  severe  coughing  spell.  The  respiration  is 
always  dyspnoeic  and  accompanied  by  a  stenotic  bruit  when  from  the  results 
of  some  diseased  condition  there  is  a  contraction  of  the  larynx.  Ausculta- 
tion of  the  larynx  is  performed  by  placing  the  ear  directly  on  the  larynx. 
Normally  the  sound  is  a  slightly  wheezy  respiration.  Rubbing,  creak- 
ing, or  rattling  sounds  indicate  more  or  less  liquid  accumulations  (mucus, 
pus,  or  blood) ;  wheezy,  gasping,  snoring  sounds  indicate  severe  swelling 
of  the  mucous  membrane  or  tough  mucus  (chronic  catarrh) ;  it  may  also 
indicate  the  presence  of  tumors,  membranous  accumulations,  and  par- 
alysis of  the  muscles  of  the  larynx. 

A  local  external  and  internal  examination  of  the  larynx  can  be 
made.  Externally  the  larynx  can  be  examined  to  see  whether  it  is 
swollen,  as  in  acute  laryngitis;  for  fracture  or  dislocation  of  the  cartilages, 
for  cedematous,  phlegmonous,  or  emphysematous  swellings  of  the  part 
or  its  surroundings,  and  sensitiveness  to  pressure,  always  indicates  some 
irritation  of  the  larynx. 

The  internal  examination  of  the  larynx  is  very  easy  and  simple  except 
in  cases  where  the  animal  is  very  vicious;  the  method  of  keeping  the  mouth 
open  is  fully  described  on  page  12,  and  then  by  means  of  a  spatula,  or  the 
handle  of  a  spoon,  the  tongue  can  be  depressed  or  pulled  out  of  the  mouth 
with  a  pair  of  blunt  forceps;  the  examination  should  be  made  near  a  win- 
dow or  by  means  of  a  lamp  or  electric  torch;  the  light  can  then  be  thrown 
into  the  posterior  portion  of  the  throat.  Vicious  animals  may  be  put 
under  ether  or  stupefied  by  morphine.  When  the  mouth  is  opened  and 
the  tongue  depressed,  we  can  easily  see  the  entire  pharynx  and  the  upper 
wall  of  the  larynx  and  epiglottis,  and  in  some  cases  a  part  of  the  windpipe, 
and  swellings,  discolorations,  hemorrhages,  ulcerations,  new  formations, 
foreign  bodies,  paralysis  of  the  vocal  chords  can  be  readily  diagnosed;  a 
good  knowledge  of  anatomy  and  a  quick  eye  is  necessary,  however.  In 
acute  catarrh  the  mucous  membrane  of  the  larnyx  is  injected  and  red  and 
covered  with  slimy  white  or  yellowish  mucus.  In  chronic  catarrh  it  is 
not  so  red,  but  the  mucous  membrane  has  a  number  of  bluish-red  vessels 
running  through  it  and  covered  with  tough,  glassy,  or  purulent  mucus; 
the  membranes  are  sometimes  granular;  we  may  also  find  at  the  entrance 
of  the  oesophagus  foreign  bodies,  tumors,  or  abscesses.  The  trachea  is 
examined  externally  by  palpation  to  sec  if  there  is  any  change  or  disloca- 
tion of  the  rings,  cedematous  or  phlegmonous  swellings  of  the  surrounding 
structures  and  enlargement  of  the  thvroid  gland. 


PHYSICAL  DIAGNOSIS  OF  THE  LUNGS  119 

Physical  Diagnosis  of  the  Lungs. 

The  lungs  of  the  dog  consist  of  a  number  of  layer-like  portions  which 
are  united  by  the  bronchi  and  connective  tissue;  the  anatomical  posi- 
tions of  the  lungs  are  shown  in  Figs,  55  and  50.  The  left  lung  is  divided 
into  two  portions  or  lobes,  an  anterior  and  a  posterior;  the  former  is 
again  subdivided  in  two;  this  division  is  not  very  distinct  in  some  eases. 
The  section  that  divides  the  large  loljes  begins  opposite  the  fourth  and 
fifth  vertebne  and  runs  downward  and  backward  as  far  as  the  sixth  rib; 
the  anterior  lobe  extends  as  far  as  the  first  rib,  and  anteriorly  and  pos- 
teriorly to  the  sixth  rib;  the  large  posterior  lobe  extends  back  as  far  as  the 
eleventh  or  twelfth  vertebra,  where  it  extends  upward  and  lies  between 
the  vertebra?  and  the  diaphragm.  The  left  lung  has  a  small  incision  near 
the  heart,  called  the  heart  incision.  The  right  lung  is  somewhat  larger 
than  the  left,  and  extends  as  far  back  as  the  twelfth  or  thirteenth  verte- 
bra; it  is  divided  into  four  lobes,  the  posterior  lobe  being  considerably 
larger  than  the  corresponding  lobe  of  the  left  lung.  The  cardiac  lobe  lies 
upon  the  heart,  almost  surrounding  that  organ;  the  other  lobes  hold  the 
same  relation  as  they  do  in  the  left  lung.  The  middle  lobe  of  the  lungs  is 
a  club-shaped  portion  that  lies  in  a  special  groove  in  the  mediastinum,  ex- 
tending anteriorly  as  far  as  the  heart  and  posteriorly  to  the  diaphragm. 

In  making  an  examination  of  the  lungs  we  must  take  into  considera- 
tion the  shape  of  the  cavity  of  the  chest,  sensitiveness  to  pressure,  the 
number  and  character  of  the  respiratory  movements,  the  character  of  the 
cough,  and  the  information  dcM'ived  from  auscultation  and  percussion. 

Shape  of  the  Cavity  of  the  Chest. — In  healthy  animals  the  two  sides  of 
the  chest  should  be  symmetrical.  A  depression  on  one  side  means  pain 
in  that  portion  of  the  chest,  dry  pleuritis,  recent  fractures  of  the  ribs,  one- 
sided contraction  of  the  lung  after  a  rapid  absorption  of  the  exudate  of 
pleurisy.  In  a  case  where  there  is  a  fractured  rib  there  may  be  a  protru- 
sion in  one  place,  an  inflammatory  condition  of  the  ribs,  and  tumors  of  the 
wall  of  the  chest;  when  the  whole  chest  seems  swollen,  it  indicates  doul)le 
pleuritis,  with  a  great  amount  of  exudate  present;  when  only  the  posterior 
half  of  the  thorax  seems  distended  and  we  find  the  abdomen  enlarged,  it 
indicates  ascites,  tumors,  or  collections  in  the  abdominal  cavity. 

Sensitiveness  to  Pressure. — This  is  produced  by  a  number  of  inflamma- 
tory conditions  of  the  skin  and  subcutis,  the  ribs,  or  the  intercostal  mus- 
cles as  in  cases  of  muscular  rheumatism,  or  in  fracture  of  the  ribs,  and 
quite  frequently  in  pleuritis;  in  this  case  there  is  pain  on  pressure  between 
the  intercostal  spaces,  and  there  may  be  great  pain  shown  when  there  is 
no  exudate;  this  is  a  verv  common  symptom.  For  further  information 
see  page  149. 


120 


DISEASES  OF  THE  RESPIRATORY  ORGANS 


Number   and    Character   of   the    Respiratory   Movements. — Normal 
breathing  is  performed  in  the  dog,  as  in  other  animals,  through  muscular  ac- 


.2   >> 


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a    ■- 

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>-    rt 
c    u 

*-  a 

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tion  in  inspiring,  and  the  elasticity  of  the  tissue  of  the  lungs  and  the  walls  of 
the  chest  in  expiration;  this  is  also  aided  by  the  pressure  of  the  intestines 


PHYSICAL  DIAGNOSIS  OF  THE  LUNGS 


121 


on  the  diaphragm.  It  is  only  when  the  respiration  is  obstructed  that  the 
assistance  of  the  muscles  of  respiration  is  required  in  expiration.  The 
works  on  physiology  give  more  minute  details  on  this  subject.  The  nor- 
mal respirations  are  from  twelve  to  twenty-eight  per  minute,  the  size  and 


0)    bO 


-e.g 


«  a 


o  «> 

^  a 

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hi  M 

U5  53 


age  of  the  animal  making  a  slight  difference,  in  the  smaller  dog,  of  course, 
being  more  f  rec[uent.  Various  conditions  tend  to  alter  the  above  number, 
such  as  running,  physical  excitement,  atmospheric  temperature,  the  pres- 
ence of  a  stranger,  particularly  if  they  handle  the  animal,  overloading  of 


122  DISEASES  OF  THE  RESPIRATORY  ORGANS 

the  stomach,  and  advanced  pregnancy.  While  the  respirations  in  the  dog 
are  regular,  yet  they  are  disturbed  more  quickly  by  physical  excitement 
than  in  any  other  animal,  and  after  any  unusual  exercise,  the  dog  will  open 
the  mouth. 

A  pathological  lessening  of  the  number  of  the  respirations,  may  be 
seen  in  all  serious  affections  of  the  brain  and  its  membranes,  in  acute  infec- 
tious diseases,  such  as  septicaemia  and  distemper  and  in  cases  of  contrac- 
tion of  the  air-passages. 

A  slight  increase  in  the  I'espirations  may  follow  any  increase  of  tempera- 
ture; they  are  also  increased,  when  any  pain  is  present,  in  circumscribed 
pleuritis,  in  the  commencement  of  peritonitis,  in  fractures  of  the  ribs,  and 
in  rheumatism  of  the  intercostals.  Laborious  respiration  (difficulty  in 
breathing,  dyspnoea)  is  seen  where  there  is  any  contraction  of  the  phar- 
ynx, larynx,  or  windpipe;  for  instance,  from  the  swelling  and  inflammation 
of  the  mucous  membrane  in  those  organs,  foreign  bodies,  tumors,  etc. 
We  see  laborious  breathing,  with  great  increase  of  the  number  of  respira- 
tions, in  any  irritation  of  the  bronchial  tubes,  where  they  become  con- 
tracted or  filled  with  mucus,  and  in  all  diseases  of  the  true  lung-tissue,  in 
all  exudates  into  the  pleural  cavity,  or  in  diseases  of  the  al)domen, 
where  there  are  collections  of  solids  or  fluids  in  the  abdominal  cavity  that 
press  on  the  diaphragm  in  cramp  or  spasm  of  the  muscles  of  respiration, 
as  in  strychnia  poisoning,  tetanus,  or  eclampsia  in  nursing  bitches,  in 
diseases  of  the  heart  where  there  is  stagnation  of  the  thoracic  cir- 
culation. In  all  cases  of  dyspnoea  in  the  dog  the  animal  rarely  lies 
down,  but  prefers  to  assume  a  sitting  position  with  the  front  legs  spread 
wide  apart. 

Cough. — The  nature  and  form  of  cough  are  very  important  symptoms 
in  all  diseases  of  the  respiratory  organs.  Cough  is  produced  by  reflex 
action  from  all  parts  of  the  mucous  membranes  of  the  pharynx,  windpipe, 
bronchi,  and  also  by  an  inflamed  pleura.  The  pulmonary  tissue  never 
produces  cough  by  reflex  irritation.  The  so-called  "stomach  cough"  is 
only  imaginary;  no  such  thing  can  truly  be  said  to  exist.  Cough  is  gener- 
ally absent  in  diseases  of  the  brain  or  in  certain  cases  of  extreme  weak- 
ness, and  just  before  death  from  poisoning,  as  well  as  in  cases  where  the 
glottis  and  the  muscles  of  respiration  are  acutely  inflamed.  Where  the 
sensitive  ends  of  the  vagus  and  particularly  the  supra-laryngeal  nerves 
become  paralyzed  it  is  impossible  to  produce  coughing  liy  manipulation 
of  the  throat.  Dogs  do  not  cough  intentionally,  and  if  it  is  very  painful 
they  can  suppress  it. 

An  animal  may  ])e  made  to  cough  by  pressing  the  sides  of  the  pharynx 
between  the  fingers;  if  the  throat  is  pressed  hard  an  animal  will  cough  and 
make  motions  very  similar  to  those  of  vomiting. 

Occasionally  an  animal  is  found  that  the  most  severe  pressure  of  the 


PHYSICAL  DIAGNOSIS  OF  THE  LUXGS 


123 


larynx  will  not  produce  any  signs  of  coughing,  although  it  may  make  a 
swallowing  movement. 

Several  spells  of  coughing,  after  a  slight  pressure  of  the  pharynx, 
point  to  a  diseased  condition  of  that  organ;  if  the  same  pressure  is  made  on 
the  windpipe,  and  the  animal  coughs  violently,  it  also  indicates  a  diseased 
contlition  of  those  parts.  In  bronchitis  and  catarrhal  pneumonia,  cough- 
ing can  be  produced  by  tapping  on  the  wall  of  the  chest,  indicating  dis- 
eased conditions  of  the  deeper  air-passages,  particularly  bronchitis,  bron- 
chopneumonia or  catarrhal  pneumonia.  Spells  of  coughing  may  be 
produced  as  a  result  of  unusual  exercise,  running,  jumping,  excitement, 
or  from  going  out  into  cold  air. 

In  the  beginning  of  acute  bronchitis  and  in  pleurisj^  the  cough  is  dull, 
w^eak,  usually  frecjuent,  dry,  and  husky.  In  chronic  em- 
physema, bronchitis,  catarrhal  or  croupous  pneumonia  the 
cough  is  soft  and  frequent.  The  cough  in  emphysema  and 
oedema  is  very  much  the  same,  but  not  very  frec[uent,  and 
in  tuberculosis  it  is  hollow  and  dull.  There  are  many  ex- 
ceptions to  this  rule;  for  instance,  in  cases  where  foreign 
bodies  enter  the  lung  through  the  mouth  or  following  vom- 
iting, the  cough  is  convulsive  and  violent,  resembling- 
whooping-cough  (chronic  pharyngeal  catarrh)  in  its  inten- 
sity. As  a  rule  dogs  cough  more  freciuently  at  night  than 
during  the  day. 

The  expectorations  cannot  be  examined  in  the  dog  as 
in  man,  as  the  animal  generally  swallows  all  the  secretions; 
in  rare  instances  there  may  be  a  small  portion  of  the  mucus 
thrown  out  of  the  mouth  or  nose  in  coughing.  We  can 
often  see  the  animal  chewing  or  swallowing  after  a  fit  of 
coughing,  which  indicates  that  the  animal  has  brought  up 
a  piece  of  mucus  into  the  mouth  or  pharynx;  this  is  seen 
when  the  cough  becomes  loose,  moist,  or  rattling,  and  is 
what  is  termed  "looseness"  of  the  cough,  being  seen  gener- 
ally in  pharyngeal,  tracheal,  and  bronchial  catarrh.  The 
largest  amount  of  excretion  is  seen  in  bronchial  and  tubercular  diseases, 
while  in  catarrhal  and  croupous  pneumonia,  and  also  in  certain  forms  of 
bronchitis,  we  find  the  excretion  is  thick  and  firm  and  accompanied  by 
dry,  laborious  coughing  spells,  and  at  the  end  of  the  cough  there  is  a 
swallowing  movement.  In  hemorrhage  of  the  lungs  the  cough  is  accom- 
panied by  more  or  less  foamy  blood  from  the  nostrils  and  mouth  and 
in  some  cases  symptoms  of  choking;  a  slight  hemorrhage  may  escape  our 
observation,  as  generally  all  the  blood  is  swallowed. 

Percussion  of  the  Thorax. — Percussion  (tapping)  is  performed  by 
means  of  a  percussion  hammer  and  an  ivory  or  metal  plate  (pleximeter) 


Fig.  57.— riex- 
iinetcr. 


124 


DISEASES  OF  THE  RESPIRATORY  ORGANS 


(Fig.  57).  Lay  the  plate  close  to  the  wall  of  the  chest,  and,  with  the  hammer 
in  the  other  hand,  strike  the  plate  a  number  of  light,  quick  taps;  the  fingers 
can  also  be  used,  and  are  preferred  by  some.  Place  the  index  or  middle 
finger  of  the  left  hand  firmly  on  the  chest  wall,  and  with  the  index  finger 
of  the  right  hand  tap  on  the  finger  of  the  left  hand. 

The  limits  of  percussion  arc  given  in  Fig.  58,  but  it  must  be  taken  into 
consideration  that  on  expiration  the  posterior  limit  of  the  lungs  is  carried 
forward  of  the  dotted  line  and  not  extending  to  the  last  rib  and  also  that 
when  the  stomach  or  intestines  are  very  much  filled  with  gas,  and  crowd 
the  diaphragm  forward,  the  extent  of  the  lungs  is  lessened.  The  per- 
cussion area  lies  in  a  triangular  space  between  the  lower  side  of  the  mus- 


FiG.  58. — Field  of  percussion;  x,  location  of  heart  beat. 

cles  of  the  back,  the  posterior  portion  of  the  muscles  of  the  forearm,  and 
the  ends  of  the  ribs,  and  by  pulling  the  forelegs  forward,  the  extent  of  the 
chest  wall  can  be  increased  for  examination.  In  percussion  we  make  the 
distinction  between  a  clear,  loud,  normal  lung  sound  and  a  tympanitic, 
dull,  or  solid  sound  of  a  diseased  lung.  The  clear  normal  sound  of  the 
healthy  lung  is  heard  all  over  the  thorax,  the  volume  of  sound  depending 
on  the  thickness  of  the  lung  at  the  particular  part  being  examined.  The 
muscular  layers  of  the  chest  have  a  certain  effect  on  the  sound,  very  thick 
walls  lessening  the  sound  to  a  certain  extent;  the  soimd  is  more  or  less 
dull  over  the  shoulder-blade,  sterum,  and  back;  the  posterior  borders  of 
the  lungs  often  have  no  perceptible  sound,  as  they  are  so  thin. 


PHYSICAL  DIAGNOSIS  OF  THE  LUNGS  125 

A  dull,  muffiod  sound,  which  has  been  mentioned  in  the  above  classifi- 
cation, is  heard  in  the  following  conditions:  In  the  tissues  of  the  lung, 
where  the  air  cannot  reach,  as  in  hepatization;  in  croupous  pneumonia;  in 
tuberculosis,  provided  that  the  diseased  centre  is  not  entirely  surrounded 
with  tissue  containing  air;  in  tumors  of  the  lungs;  in  hemorrhagic  infarc- 
tion; in  sections  of  the  lungs  that  are  compressed  by  pleuritic  or  pericar- 
dial effusions.  (Edema  of  the  lung  is  only  accompanied  with  dulness 
when  it  is  well  advanced. 

The  dull  sound  is  present,  when  an  abnormal  medium  is  between  the 
lungs  and  the  pleximeter,  as  in  the  various  pleural  diseases;  tumors  of  the 
pleura;  pleuritic  or  dropsical  effusions;  and  also  in  certain  pathological 
alterations  of  the  chest,  as  in  oedema,  or  tumors.  The  more  the  tissues 
fill  up  near  the  walls  of  the  chest  and  the  greater  the  density  of  the 
medium  between  the  pleximeter  and  the  lungs,  the  more  in- 
distinct and  muffled  the  sound  becomes. 

The  tympanitic  sound  is  heard  where  there  is  any  cavity 
or  hollow  in  the  lungs,  as  in  pneumothorax.  In  the  alteration 
of  the  tension  of  the  parenchyma  of  the  lungs,  we  find  the 
sound  above  pleuritic  exudates  and  in  the  neighborhood  of 
large  tumors  of  the  lungs,  or  in  compression  of  the  lungs 
from  the  pushing  forward  of  the  diaphragm  due  to  tumors,  or 
ascites.  It  is  also  heard  in  moistening  of  the  alveoli  by  fluids 
and  reduction  of  the  contained  air,  as  in  the  loose  moist  stage 
of  croupous  pneumonia;  and  where  there  are  many  small  tuber- 
cular centres,  in  the  tissue  of  the  lungs,  which  are  hollow  in  the 
centre  and  contain  air,  and  it  is  sometimes  heard  in  oedema  of 
the  lungs.     Cutaneous  emphysema  of  the  walls  of  the  chest      ^^°-  ^^•~* 

•    •  1         mi  Tn  Stethoscope. 

gives  a  clear  tympanitic  sound.     There  are  several  modifica- 
tions of  this  sound,  such  as  the  cracked-pot  or  metallic,  tinkling  percus- 
sion sound,  but  these  are  not  of  much  diagnostic  value,  as  they  appear 
only  when  there  may  be  large  cavernous  spaces  in  the  walls  of  the 
chest. 

Auscultation  of  the  Lungs. — This  is  performed,  either  by  putting  the 
ear  directly  against  the  walls  of  the  chest,  over  the  affected  region  (direct 
auscultation),  or  by  using  a  stethoscope  (Fig.  59)  (indirect  auscultation). 
(A  form  of  stethoscope  called  the  "  membranate  stethoscope,"  a  modifica- 
tion of  the  phonograph,  has  lately  been  introduced  and  used  in  the  larger 
animals  with  considerable  success,  but  the  person  using  it  must  be  thor- 
oughly familiar  with  the  chest  sounds  and  also  with  the  instrument  to 
get  the  best  results,  but  the  writer  finds  that  on  account  of  its  size  it  is  not 
of  much  practical  use  in  the  dog.)  The  first  method  is  the  best,  especially 
with  restless  animals. 

The  ear  distinguishes  the  true  respiratory  and  accessory  sounds.     In 


12G  DISEASES  OF  THE  RESPIRATORY  ORGANS 

the  former  we  hear  a  vesicular  respiratory  bruit,  which  has  a  hipping  char- 
acter, and  the  bronchial  respiratory  bruit,  which  is  a  Jjlowing  murmur, 
and,  lastly,  an  indistinct  respiratory  bruit,  which  is  a  slight  soft  murmur. 

The  vesicular  respiratory  bruit  is  heard  when  any  portion  of  the  lung 
that  is  filled  with  air  lies  against  the  wall  of  the  chest.  In  normal  inspira- 
tion the  sound  is  a  smooth,  regular  murmur,  the  air  going  directly  into  the 
alveoli  without  any  resistance.  This  sound  can  be  increased  very  much 
even  during  health  by  active  movements  or  during  excitement;  it  is  also 
much  clearer  and  louder  in  emaciated  animals  where  the  walls  of  the  chest 
are  thin.  The  vesicular  murmur  is  always  much  louder  in  young  animals, 
and  especially  in  puppies;  the  murmur  is  also  noted  in  expiration  in 
animals  under  nine  months.  According  to  the  amount  of  irritation,  the 
vesicular  murmur  is  lessened  in  bronchial  catarrh  where  there  is  much 
swelling  of  the  mucous  membrane  and  secretions  collected,  in  stenosis  of 
the  upper  air-passages,  in  emphysema  of  the  lungs,  in  certain  stages  of 
catarrhal  pneumonia,  in  pleuritic  or  dropsical  exudations,  in  thickening 
of  the  pleura  from  the  deposit  of  lymph-masses,  tumors  or  oedema. 

It  disappears  entirely  in  croupous  pleuritic  effusions,  in  pneu- 
mothorax, and  in  closure  of  one  of  the  large  bronchial  tubes. 

The  vesicular  murmur  is  increased  in  dyspnoea  in  portions  of  the 
lungs  that  are  healthy  when  other  parts  are  diseased,  the  healthy  portions 
doing  all  of  the  work;  this  is  especially  seen  in  bronchitis,  where  the 
smaller  bronchi  are  plugged  up  with  secretions.  We  occasionally  find 
an  irregular  vesicular  murmur  in  healthy  dogs,  but  it  is  also  heard  in 
cases  of  bronchitis;  this  murmur  is  heard  only  on  inspiration. 

The  murmur  of  expiration  is  very  slight;  in  normal  cases  it  can  hardly 
be  heard;  it  is  quite  plain  when  the  breathing  is  strong  after  excitement, 
action,  etc.,  especially  in  young  dogs  and  those  animals  that  have  a  thin 
chest  wall.  According  to  the  diseased  condition,  the  sound  is  strength- 
ened, varied  in  tone,  and  prolonged. 

The  bronchial  respiratory  bruit  (bronchial  breathing,  wheezing 
sound)  may  be  heard  in  the  normal  respiration  of  the  pharynx,  wind- 
pipe, and  the  anterior  part  of  the  chest  in  diseased  conditions;  it  appears 
where  any  part  of  the  lung  is  deprived  of  air,  and  the  disease  has  plugged 
up  the  smaller  bronchi  and  extended  to  the  larger-sized  bronchi.  This  is 
the  case  in  the  various  pulmonary  affections,  where  we  find  large  sections 
of  the  lungs  are  obstructed,  or  in  compression  of  the  lung  by  a  pleuritic 
exudate  or  by  tumors,  and  in  rare  cases  by  the  pressure  of  the  diaphragm 
where  it  is  pushed  forward  from  the  collections  of  fluids  in  the  abdomen. 
It  is  also  heard  when  a  quantity  of  mucus  is  coming  up  the  bronchial 
tubes;  this  sound  disappears  when  the  mucus  is  coughed  up.  Lastly, 
we  find  it  in  cases  where  the  lung  has  large  cavernous  spaces  in  it. 

Indistinct  respiratory  bruits  are  heard  in  lobular  pneumonia,  where 


PHYSICAL  DIAGNOSIS  OF  THE  LUNGS  127 

the  diseased  lolndes  are  located  among  clear  tissue  that  the  air  is  passing 
into,  and  where  the  true  character  of  the  respiratory  bruit  is  not  heard  on 
account  of  the  loud  rattling  of  the  air  going  through  the  contracted 
bronchial  tubes.  Indistinct  respiratory  sounds  are  also  heard  where  there 
is  more  or  less  mucus  in  the  bronchial  tubes,  and  after  the  animal  has 
had  a  coughing  spell  the  true  bronchial  sound  is  heard. 

Irregular  bronchial  sounds  (rattling  bruits)  are  caused  by  the  move- 
ment of  the  mucus  or  fluids  that  are  in  the  air-passages,  being  carried 
to  and  fro  by  the  passage  of  air.  The}^  are  dry  (snoring,  wheezing)  where 
a  small  ciuantity  of  sticky  mucus  collects  in  the  bronchial  tubes,  as  is  seen 
in  some  catarrhal  affections  and  in  cases  where  the  mucous  membrane  is 
considerably  swollen.  The  snoring  sound  is  generally  heard  in  the  large 
bronchial  tubes.  The  wheezing  sounds  occur  in  the  smaller  bronchial 
tubes.  A  spell  of  coughing  produces  considerable  change  in  the  character 
of  the  slight,  rattling  sounds  of  the  chest.  The  rattling  sounds  are  moist 
Avhen  the  secretions  are  lic|uid;  the  thicker  they  are  the  duller  the  bruits 
become.  We  hear  moist,  rattling  sounds  when  the  secretions  are  col- 
lected in  the  large  bronchi;  this  sound  is  also  heard  when  there  are  caver- 
nous portions  in  the  lungs.  We  find  much  less  when  this  is  the  case  in 
the  middle  bronchi,  and  a  very  low  bronchial  bruit  when  the  small 
In-onchi  are  involved.  By  this  means  we  can  distinguish  in  what  posi- 
tion the  irritation  lies  in  the  bronchi;  this  is  rather  important  in  diagnos- 
ing a  case  of  bronchitis.  AVhen  the  fine  bronchioles  are  involved  it  has  a 
crackling  or  crepitant  sound  and  sibilant  bruits;  these  are  only  heard 
during  inspiration.  This  sound  may  sometimes  be  heard  in  the  alveolar 
passages  and  in  the  alveoli  themselves,  when  they  are  filled  with  mucus 
or  closed  up,  and  where  the  air  can  reach  them  only  by  strong  inspiration. 
This  is  seen  in  the  first  and  third  stages  of  croupous  pneumonia,  in  oedema 
of  the  lungs,  and  in  capillary  bronchitis;  in  the  last,  the  crepitation  is 
mixed  with  an  irregular  rattling  sound.  We  find  also  the  friction  sound 
of  the  pleura;  this  is  not  heard  in  the  normal  condition,  but  in  disease;  it 
is  either  crepitating,  scraping,  or  scratching.  It  is  heard  in  pleurisy;  as  a 
rule  it  is  louder  on  inspiration  than  expiration.  This  sound  is  produced 
by  collections  of  fibrinous  accumulations  on  the  pleura.  These  sounds 
are  not  heard  when  the  pleura  is  separated  by  an  exudate.  The  sound  is 
plainest  at  the  commencement  of  the  disease,  and  when  the  exudate  is 
being  absorbed.  This  sound  is  not  altered  by  coughing,  and  in  this  way 
can  be  distinguished  from  rattling  sounds  which  are  heard  when  it  is  a 
case  of  pleuro-pneumonia.  The  rubbing  sound  caused  by  the  broken 
ends  of  a  fractured  rib  is  indicated  by  the  crepitation  on  movement  of  the 
ends  of  the  rib. 


128  DISEASES  OF  THE  RESPIRATORY  ORGANS 

DISEASES  OF  THE  NASAL  CAVITIES. 

Catarrh  of  the  Nose. 

(Cold  in  the  Head;  Coryza;  Rhinitis;  Nasal  Catarrh.) 

Etiology. — Catarrh  of  the  nose  (catarrhal  inflammation  of  the  nasal 
mucous  membranes)  occurs  very  frequently  and  originates  from  local 
causes  (dust,  smoke,  pentastomum  tsenioides,  foreign  bodies)  or  by  cold. 
Coryza  is  also  a  symptom  of  distemper,  and  may  appear  secondarily 
in  any  inflammation  of  the  other  mucous  membranes  of  the  head.  Where 
a  large  number  of  dogs  are  kept  together,  it  may  occur  as  an  epizootic  or 
may  result  from  being  bathed  in  cold  weather  and  not  being  properly 
dried,  clipping  or  shaving  the  hair,  or  from  ulceration  of  the  nasal 
passages. 

Clinical  Symptoms  and  Course. — These  are  sneezing,  wiping  the  nose 
with  the  paws,  or  rubbing  it  against  some  object.  Later  a  nasal  dis- 
charge, which  is  watery  and  liquid  at  first  and  later  becomes  turbid, 
thicker,  and  more  tenacious;  and  it  may  become  purulent,  according 
to  the  complications  that  may  appear  later  on.  If  the  cavities  in  the 
upper  chamber  of  the  nose  are  affected,  the  discharge  is  very  profuse  and 
there  is  more  or  less  disturbance  of  the  general  system.  When  the  catarrh 
is  confined  to  the  anterior  chambers  the  nasal  cavities  are  often  very 
much  contracted  and  we  hear  a  snuffling  nasal  bruit;  and  if  the  chamber 
is  very  much  contracted  we  may  see  dyspnea,  and  the  animal  is  then 
compelled  to  breathe  through  the  mouth.  This  is  apt  to  occur  more  in 
those  dogs  that  have  narrow,  twisted,  or  curved  nasal  chambers,  as  in  the 
case  of  the  pug  and  bull  dog.  True  bleeding  of  the  nose  (epistaxis),  or 
mucus  streaked  with  blood,  is  very  seldom  seen.  The  duration  of  a 
case  of  nasal  catarrh  is  usually  short;  although  we  may  occasionally 
see  a  case  where  there  is  a  tendency  to  a  chronic  condition;  in  such  a 
case,  the  secretion  becomes  purulent  and  has  a  tendency  to  dry  around  the 
nose,  forming  a  dirty  crust  around  the  nostrils  and  the  upper  lip  (see 
later  under  Pentastomum  tsenioides) ;  in  such  cases  the  mucous  membrane 
is  dry,  corrugated  and  frequently  gray  in  color,  the  breath  may  remain 
foetid,  resisting  all  palliative  treatment,  and  may  continue  as  a  chronic 
condition  and  affect  the  animal  all  through  life.  In  very  bad  cases  the 
secretion  is  purulent,  with  a  very  bad  odor,  and  in  rare  instances  streaked 
with  blood.  This  is  specially  the  case  where  the  pentastomum  tspnioides 
is  the  cause  of  the  diseased  condition  of  the  mucous  membrane. 

Therapeutics. — Xasal  catarrh  will  generally  disappear  without  any 
special  treatment.  To  protect  the  neighboring  tissue  from  the  excoria- 
tion of  the  tissues  caused  by  the  discharge  it  is  well  to  keep  it  clean 
with  tepid  water  and  a  little  borax,  or  to  coat  the  part  with  vaseline  or 


CATARRH  OF  THE  NOSE  129 

oxide  of  zinc  ointment.  In  all  mucous,  purulent,  or  chronic  catarrhs 
spray  the  nose  ^yith  a  2  per  cent,  solution  of  creolin,  or  coat  around  the 
nostril  with  vaseline  or  oil.  In  acute  catarrh  it  is  best  to  spray  the 
nostril  with  an  atomizer,  using  either  of  the  following  solutions:  creolin, 
2  per  cent.;  carbolic  acid,  2  per  cent.;  boric  acid,  3  per  cent.;  the  inhala- 
tion can  be  given  in  the  form  of  warm  solutions,  allowing  the  animal  to 
inhale  the  steam  from  them  by  the  method  described  in  the  treatment  of 
chronic  catarrh  of  the  larynx  on  page  136,  or  with  an  atomizer;  infusion 
of  chamomile,  carbolated  water,  tar  water,  and  oil  of  turpentine  have 
been  used  with  good  results.  Foetid  discharges  from  the  nasal  cavity  may 
be  treated  by  injections  or  local  applications  but,  as  a  rule,  animals  resist 
treatment,  and  the  excitement  and  irritation  to  the  animal  does  much 
more  harm  than  good.  The  vapor  apparatus  described  on  page  136,  is 
much  simpler  and  produces  good  results.  Painting  the  nasal  cavity 
with  a  1  to  5  per  cent,  solution  of  cocaine  will  anaesthetize  the  mucous 
membrane  and  lessen  the  irritation  of  the  animal;  an  atomizer  maybe  used 
or  powder  applied  by  means  of  an  insufflator  is  useful  to  make  local  appli- 
cations to  the  nose;  in  making  such  local  applications  care  must  be  taken 
to  have  the  patient's  head  dependent  and  use  very  little  force  in  the  appli- 
cation, so  the  injection  may  traverse  only  the  nasal  cavity  and  not  be 
driven  into  the  larynx  and  into  the  lungs.  The  mild  albuminous  solu- 
tions of  silver  may  also  be  used. 

Other  Diseases  of  the  Nasal  Cavities. 
Bleeding  at  the  Nose  (Epistaxisj. 

This  is  a  result  of  traumatic  or  mechanical  causes,  such  as  blows,  bites, 
lacerations,  or  the  entrance  of  foreign  bodies  into  the  nasal  cavities;  it 
also  results  from  acute  or  chronic  catarrh,  pathological  growths,  parasites 
in  the  nasal  cavity,  congestion  or  rush  of  blood  to  the  nasal  region,  infect- 
ious diseases,  parasites  (pentastomes) ,  or  hemorrhage  from  the  lungs. 

Violent  bleeding  at  the  nose  can  be  controlled  by  injections  of  cold 
water  or  a  3  per  cent,  solution  of  chloride  of  iron  into  the  nostril.  It  is 
very  difficult  to  place  a  tampon  in  the  dog's  nose  that  will  be  efficient,  on 
account  of  the  anatomical  peculiarities. 

AVhen  the  pentastomum  is  present,  the  only  efficient  way  to  get 
at  it  is  to  trephine  the  frontal  bones,  so  that  agents  can  be  injected 
directly  into  the  location  of  the  parasites.  For  this  operation  refer  to  the 
text-books  on  surgery. 

Treatment. — Xo  treatment  is  generally  required,  as  the  majority 
of  attacks  of  epistaxis  stop  spontaneously  if  the  animal  is  kept  quiet. 
In  persistent  cases  make  applications  of  cold  water  to  the  head  or  solu- 
tions of  ec|ual  parts  of  vinegar  and  alum  are  injected  into  the  nose,  or  in- 
9 


130 


DISEASES  OF  THE  RESPIRATORY  ORGANS 


j(>ctions  of  vinegar  and  water,  equal  parts,  3  to  5  per  cent,  solution  of 
alum,  tannin,  chloride  of  iron  or  antipyrin.  Tampons  are  rather  difficult 
to  apply,  but  if  the  bleeding  is  persistent  they  can  be  used.  Use  small 
pledgets  of  cotton  steeped  in  chloride  of  iron,  taking  care  the  plug  is  not 
pushed  in  entirely,  so  that  it  can  be  removed  later  by  means  of  forceps. 
The  best  means  of  applying  the  tampon  is  to  use  the  rapid  tampon.  The 
so-called  internal  styptics  are  useless.  The  injection  of  gelatine  solution, 
once  so  much  in  vogue,  is  not  now  used,  as  it  is  dangerous.  Anaemia  from 
exposure  and  persistent  epistaxis  is  considered  in  the  chapter  on  that 
subject. 


Fig.  60. — Dog  with  chronic  catarrh  and  pus  in  the  frontal  sinuses. 

Tumors  of  the  Nasal  Cavities. 

These  may  be  indicated  by  a  swelling  or  alteration  of  the  nostril  or 
the  adjacent  structures;  frequently  osteo-sarcomas  involve  the  nasal 
septum,  palate  or  superior  maxilla,  the  new  growth  absorbing  or  dis- 
turbing the  normal  anatomy  of  these  structures  and  carcinomas  convert- 
ing the  bones  into  soft  cellular  structures.  Polyps  are  sometimes  pres- 
ent and  are  removed  either  by  tortion  or  by  removing  the  nasal  bone 
and  getting  into  the  nasal  cavity. 

Catarrh  and  Pus  in  the  Frontal  Sinuses. 


This  may  result  from  traumatisms  or  from  pentastomes  (see  later) 
or  new  formations  in  the  frontal  sinuses,  as  a  result  of  nasal  catarrh, 
indicated  by  swelling  and  dulness  on  percussion  of  the  frontal  sinuses 
(see  Fig.  60).  Acute  catarrh  of  the  frontal  sinus  may  result  as  a  sequel 
of  influenza;  as  a  rule,  however,  it  is  spontaneously  absorbed.     If  it  is 


CATARRH  OF  THE  NOSE 


131 


chronic,  the  pus  may  be  lilxn-ated  by  trephining,  and  the  cavities  washed 
out  with  astringent  solutions,  peroxide  of  hydrogen,  zinc,  lead,  or  alum. 

Pentastoma  and  Pentastoma  Influenza  (Linguatula 
Taenioides). — This  ta-nia-like  })arasite,  which  l)elongs  to 
the  class  of  archnides,  and  ortler  of  Linguatukc,  has  a 
flat,  tongue-like  body,  which  is  indented  at  its  borders 
and  composed  of  90  to  100  segments,  making  the  body 
have  a  saw-like  appearance,  and  is  whitish-yellow  in 
color  (see  Fig.  Gl).  The  female  is  80  to  95  mm.  and  the 
male  18  to  20  mm,  long,  both  sexes  about  1  to  2  mm. 
wide. 

These  parasites  are  found  in  the  sinuses  of  the  fore- 
head and  the  upper  nasal  chambers  (Fig.  02) ;  they  may 
also  find  their  way  into  the  pharynx,  where  they  are 
developed  sexually.  The  eggs  are  yellowish-l:)rown,  as 
many  as  500,000  being  found  in  one  female;  these  eggs 
are  attached  to  some  vegetable  substance  eaten  with  the 
vegetable  food  by  a  herbivorous  animal  or  man.  In  the 
stomach  it  becomes  free  when  the  shell  is  dissolved  and 
reaches  the  liver  in  various  ways.  It  is  found  in  the 
spleen,  kidneys,  peritoneum,  and  in  rare  instances  in  the 
lungs,  where  it  becomes  encysted;  this  is  the  sexless  larval  form, 
pentastomum  denticulatum  (Linguatula  denticulata)  (Fig.  63).  It  re- 
sembles the  sexed  parasite   in  general  shape,   except  that  it  is  much 


Fig.    61.— Pen- 
tastoma taenioides. 


Fig.  62. — Cross-section  of  the  head  of  a  dog  with  pentastoma  in  the  nasal  cavity. 

smaller,  from  4  to  5  mm.  long,  and  in  its  anterior  part  about  1.5  mm. 
wide.  It  lies  in  a  detached  cyst  which  is  about  5  mm.  long.  In 
six  months  it  becomes  sufficiently  developed  to  break  through  the 
cyst-wall,  and  by  direct  migration  finds  its  w'ay  to  the  bronchial 
tubes;    it    is    coughed    up    from    the    lungs    of    the    host    and     finds 


132 


DISEASES  OF  THE  RESPIRATORY  ORGANS 


Fig.    63.  —  Pentasto 
mum  denticulatum. 


its  way  into  the  nasal  cavities  of  the  dog  through  the  food  or  is  carried 
into  the  nose  in  respiration  and  crawls  up  into  the  nasal  cavities.  While 
the  disease  is  rarely  observed,  numerous  cases  seem  to  occur  in  certain 
districts. 

The  majority  of  observers  consider  the  disease  rather  difficult  to  diag- 
nose and  generally  it  is  only  when  it  involves  a  number 
of  animals,  such  as  a  pack  of  hounds  or  carriers,  or  in 
one  of  the  districts  where  it  is  prevalent,  that  it  is 
noticed.  The  larger  breeds  of  dogs  are  most  frecjuently 
affected  and  show  the  symptoms  of  chronic  nasal 
catarrh. 

Pentastomum  catarrh  differs  from  ordinary 
nasal  catarrh,  from  the  fact  that  in  pentastomum 
catarrh  there  is  a  more  or  less  bloody  nasal  discharge 
which  is  very  purulent  and  putrid,  and  that  the 
animal  is  greatly  depressed.  There  is  marked  inter- 
ference with  respiration,  the  animal  appearing  at 
times  to  almost  suffocate;  the  sense  of  smell  is  gen- 
erally lost  or  is  very  slight;  it  becomes  emaciated  and 
sneezes  a  great  deal  oftener  than  in  ordinary  catarrh. 
An  instance  is  recorded  where  the  parasite  pene- 
trated the  hard  palate,  causing  a  great  flow  of  saliva. 
In  some  cases  the  inflammation  has  extended  from  the  nasal  cavities  to 
the  cranial  cavity  and  produced  meningitis  with  severe  cerebral  symp- 
toms, great  excitement,  restlessness,  and  a  tendency  to  biting  or  snap- 
ping, and  also  paralysis  of  the  lower  jaw  and  several  symptoms  very 
similar  to  those  of  rabies. 

Friedberger  and  Frohner  advise  that  in  all  cases  where  there  are 
symptoms  of  rabies,  that  the  frontal  sinuses  he 
examined,  as  there  are  often  cases  where  the  pen- 
tastomum is  present  and  it  maj^  produce  cerebral 
symptoms,  and  even  death,  without  any  marked 
alteration  in  the  mucous  membranes  of  the  nasal 
passages.  At  the  same  time  it  is  possible  in  rare 
instances  to  find  a  pentastomum  in  a  dog  that  has  ^^^  64 —Egg  of  the  pen- 
died  from  true  rabies.  The  writer  may  mention  tastomum  ta>noides  magni- 
that  he  has  also  found  cerebral  symptoms  in  an  "  "  ""^^' 
animal  that  has  been  suffering  from  purulent  (non-parasitic)  nasal 
catarrh. 

Treatment  of  pentastoma  consists  in  the  injection  into  the  nose  of 
solutions  (either  by  means  of  a  syringe  or  ])y  an  atomizer)  of  boracic  acid, 
creolin,  chloroforhi,  lienzine,  carbolic  acid,  or  liy  the  application  of  the 
vapors   of   chloroform,   formaldehyde,  etc.     All  these  preparations  are 


ACUTE  LARYNGEAL  CATARRH  133 

rather  difficult  to  apply,  on  account  of  the  narrowness  of  the  nasal  pas- 
sage in  the  dog.  In  very  acute  cases,  the  best  method  of  procedure  is  to 
trephine  the  upper  part  of  the  nasal  passage  and  going  directly  into  that 
cavity  inject  it  with  solutions  of  turpentine,  chloroform,  corrosive  subli- 
mate solution  and  wash  out  the  parasite.  This  can  be  accomplished  by 
using  a  good  sized  syringe  filled  with  the  solution  (creolin  1,  water  15,  or 
emulsion  of  turpentine  in  linseed  oil  1  to  10)  and  putting  a  small  section 
of  rubber  hose  on  the  end  of  the  syringe;  insert  it  into  the  opening  and 
inject  slowly,  taking  care  to  see  that  the  animal's  nose  is  depressed  and  so 
allow  the  flow  to  go  over  the  location  of  the  parasites. 

DISEASES  OF  THE  LARYNX. 

Acute  Laryngeal  Catarrh. 

(Acute  Laryngitis) . 

This  is  generally  observed  in  the  spring  and  autumn,  and  at  times 
seems  to  be  epidemic;  it  may  be  caused  by  lying  in  a  draught,  being 
bathed  in  cold  weather,  cutting  the  coat  too  early,  or  sudden  changes  of 
temperature.  It  is  found  more  frequently  in  delicate  or  pampered 
dogs,  these  animals  catching  cold  much  more  easily  than  hardier  animals. 

Etiology. — The  most  common  cause  of  catarrh  of  the  larynx  is  cold; 
laryngitis  rarely  originates  from  direct  irritation  by  agents  that  affect 
the  mucous  membrane  of  the  larynx,  such  as  inhalation  of  smoke,  dust, 
irritating  gases,  foreign  bodies,  etc.  It  may  result  from  constant  barking, 
as  when  an  animal  is  exhibited  at  a  show  and  barks  constantly,  or  through 
lying  near  a  fire  and  getting  very  warm  and  then  going  and  lying  at  the 
door,  where  the  draught  will  come  on  the  head  and  throat.  Laryngitis 
appears  as  a  secondary  symptom  of  acute  inflammation  of  the  nose, 
trachea,  and  bronchi,  and  it  is  generally  one  of  the  precursory  symp- 
toms of  distemper. 

Pathological  Anatomy. — The  mucous  membrane  of  the  larynx  is 
partially  or  entirely  reddened,  inflamed,  and  swollen,  and  covered  with 
mucus  over  its  entire  surface;  this  mucus  is  rarely  purulent;  in  serious 
cases,  the  membrane  is  eroded  or  ecchymosed  in  spots. 

Clinical  Symptoms. — The  first  noticeable  symptom  is  a  cough; 
this  may  be  very  loud,  according  to  the  condition;  it  is  always  coarse, 
hard,  and  dry  in  the  beginning;  later  it  becomes  softer  and  more  moist 
as  it  is  accompanied  with  the  secretions  of  mucus,  and  the  animal  may 
retch  and  act  as  if  going  to  vomit. 

By  a  slight  pressure  on  the  glottis  we  can  make  the  animal  cough, 
and  the  larynx  seems  to  be  painful  on  manipulation;  running,  excitement, 
drinking  cold  water,  or  the  administration  of  medicine  all  produce 
coughing.     Difficulty  in  respiration  is  seen  in  certain  forms  of  laryngitis 


134  DISEASES  OF  THE  RESPIRATORY  ORGANS 

where  there  is  intense  inflammation  and  great  swelling  of  the  mucous 
membrane;  it  is  accompanied  by  more  or  less  wheezy  or  rattling  sounds, 
which  can  be  heard  by  placing  the  ear  on  the  larynx.  There  is  not  much 
constitutional  disturbance  in  the  milder  forms  of  this  disease;  in  more 
acute  cases,  the  animal  is  depressed  and  eats  slowly;  this  is  probably 
caused  by  a  certain  amount  of  irritation  extending  to  the  muscles  of 
deglutition,  and  to  swelling  of  the  mucous  membrane,  or  from  some  form 
of  pharyngitis,  which  may  be  present  at  the  same  time;  if  so,  it  is  generally 
accompanied  by  a  slight  rise  of  temperature  and  loss  of  appetite.  This 
condition  in  young  dogs  should  always  be  watched  very  carefully,  as 
it  may  be  one  of  the  premonitory  symptoms  of  an  attack  of  distemper. 

The  disease  generally  lasts  only  a  few  days,  but  if  a  case  is  neglected 
and  does  not  receive  care  and  proper  treatment,  it  is  apt  to  remain  irri- 
table and  become  chronic. 

Therapeutics. — The  first  thing  to  do  is  to  remove  the  animal  from 
cold  draughts  and  apply  friction,  with  some  mild  liniment  over  the  larynx, 
also  the  application  of  a  moist  warm  compress  over  the  larynx  with  the 
inhalation  of  medicated  vapors,  a  pinch  of  belladonna  leaves  or  a  tea- 
spoonful  of  tincture  of  benzoin  in  boiling  water,  and  internally  the  admin- 
istration of  some  expectorant  or  narcotic.  These  medicines  should  only 
be  administered  when  the  cough  is  persistent  and  the  violence  of  it 
tends  to  aggravate  the  irritated  condition  of  the  mucous  membrane; 
morphine  is  the  best,  as  it  lessens  the  cough  and  irritation;  it  can  he 
administered  with  potassium  cyanide  and  syrup  of  wild  cherry.  The 
following  prescription  is  very  useful  where  the  animal  is  a  small  pet  dog, 
that  is,  one  kept  in  the  room;  it  tends  to  prevent  the  cough,  which  is 
always  worse  at  night: 

I^.     MorphiiB  sulph.,  0.1 

Aq.  amygdalis  amarse,  24.0 

Sig. — Half  a  teaspoonful  three  times  daily. 

I^.     Morphise   sulph.,  0.12 

Potassii  cyanitU,  0.15 

Syr.  pruni  virginianse,  9G.00 
Sig. — One  teaspoonful  four  times-daily. 

I^.     Ext.  hyoscyami,  1.0 

Liq.  ammon.  acetatis,  20.0 

Sig. — Twenty  drops  every  half  hour. 

I^.     Heroin  hydrocliloratis,  0.1 

Aqua-,  150.0 

S. — One  to  two  teaspoonfuls  every  six  hours. 

Occasionally  we  may  find  a  foreign  body  in  the  larynx  presenting 
the  following  symptoms:     Dyspnoea  accompanied  by  loud  coughing  or 


CHRONIC  CATARRH  OF  THE  LARYNX  135 

whistling  sounds  mingled  with  the  coughing,  great  anxiety  shown  on  the 
animal's  face;  cyanosis  of  the  mucous  membranes.  If  the  animal  is 
actually  choking,  perform  tracheotomy  immediately,  then  endeavor 
to  tlislodge  the  foreign  body  and  if  this  is  not  successful  laryngotomy  is 
indicated. 

Chronic  Catarrh  of  the  Larynx. 

{Chronic  Laryngitis;  Convulsive  Cough;  Chronic  Irritable  Cough.) 

Etiology. — Chronic  laryngitis  generally  results  from  one  or  repeated 
acute  attacks  of  laryngitis,  or  from  chronic  catarrh  of  some  of  the  other 
organs  of  the  air-passages;  the  pharynx,  trachea,  or  bronchi,  etc.  It 
may  also  follow  swelling  or  ulceration  of  the  pharynx,  or  from  the  forma- 
tion of  a  tumor  in  that  organ. 

Pathological  Anatomy. — The  mucous  membrane  is  thickened,  but 
not  so  red  as  in  acute  laryngitis;  it  is  marked  with  fissures  and  elevations 
due  to  thickening,  caused  by  the  chronic  inflammatory  processes;  and  here 
and  there  may  be  noticed  a  dirty  bluish-red  coloration.  The  surface  is 
granular,  on  account  of  the  swelling  of  the  inflamed  mucous  glands;  in  rare 
cases,  we  may  see  small  papilliform  elevations  or  small  eroded  or  ulcerated 
places  which  mark  a  breaking-down  of  some  of  the  mucous  glands;  the 
secretion  which  covers  the  aff^ected  parts  is  thick,  slimy,  and  tenacious. 

Clinical  Symptoms. — The  symptoms  are  similar  to  acute  laryngitis 
except  that  they  are  not  so  severe;  the  larynx  is  slightly  sensitive  to  pres- 
sure, sho\\ing  that  some  irritation  is  present;  the  animal  will  cough  after 
manipulation,  but  not  to  such  a  marked  degree,  and  he  does  not  try  to  get 
away  from  the  pressure,  as  Would  be  the  case  in  the  acute  form,  and 
there  is  no  disturbance  of  the  general  system.  The  cough  sounds  dry, 
hoarse,  and  rough,  sometimes  moist,  and  is  frequent,  quite  loud,  and  ac- 
companied by  a  wheezy  inspiratory  sound,  with,  in  rare  instances,  retch- 
ing or  even  emesis,  night  being  the  time  it  is  mostly  heard,  or  when  the 
animal  runs  about  and  plays  and  he  is  going  to  be  taken  out  for  a  run. 
In  some  cases  the  cough  resembles  the  whooping  cough  of  children  (tussis 
convulsiva).  As  a  rule  the  respiration  is  not  increased,  but  in  chronic 
cases  where  one  attack  follows  another  the  respiration  is  greatly  in- 
creased with  the  slightest  exertion.  Some  animals  make  a  wheezy  noise 
as  though  there  was  a  decided  contraction  of  the  larynx.  This  latter 
condition  may  continue  for  years,  and  the  cough  in  particular  is  con- 
stantly present. 

Therapeutics. — As  a  rule,  the  treatment  of  this  disease  is  unsatis- 
factory; this,  of  course,  depends  to  a  large  extent  on  the  animal.  Being 
removed  from  the  conditions  that  have  originally  caused  the  disease,  the 
first  thing  to  do  is  to  keep  the  animal  indoors,  perfectly  quiet  and  pro- 


136  DISEASES  OF  THE  RESPIRATORY  ORGANS 

tected  from  cold,  with  rest,  and  avoiding  excitement  or  prolonged  howl- 
ing. Among  the  agents  used  in  general  treatment  the  following  are  best: 
Inhalations  of  hot  medicated  solutions,  carbolic  acid,  tar,  oil  of  turpentine 
or  powdered  salt,  chlorate  of  potassium,  alum,  or  tannic  acid.  Inhala- 
tions with  these  agents  by  means  of  an  atomizer,  or  by  vapor  bath  should 
be  made  twice  daily  for  ten  or  fifteen  minutes. 

It  is  readily  understood  that  inhalations  are  rather  hard  to  admin- 
ister in  the  dog,  as  the  animal  cannot  be  kept  still  while  the  medication  is 
being  made,  and  also  because  the  dog  breathes  through  the  nose,  and  if 
prevented  from  doing  so  the  vapor  is  carried  into  the  throat  and  again 
into  the  mouth.  The  only  practical  way  to  get  an  animal  to  inhale  a 
vapor  is  to  put  him  in  a  close  box  and  through  an  opening  introduce 
steam  that  fills  up  the  apartment;  then  the  animal  has  to  inhale  it.  This, 
however,  can  be  practised  only  in  a  hospital.  But  where  the  animal  is 
at  home,  the  best  method  of  procedure  is  to  place  him  on  a  cane-seated 
chair,  and  having  placed  the  medicated  agent,  steaming  hot,  under  the 
chair,  cover  the  animal  with  a  sheet  and  hold  him  for  ten  or  fifteen  min- 
utes; or  we  may  also  hold  the  steaming  vessel  under  his  nose  and  cover  the 
head.  It  is  only  with  the  greatest  difficulty  that  the  laryngeal  mucous 
membranes  can  be  painted  with  any  medicinal  agent.  This  is  to  be  re- 
gretted, as  it  is  the  only  direct  way  that  the  membrane  can  be  treated  with 
any  certainty.  In  making  local  applications  to  the  larynx  an  assistant 
holds  open  the  mouth  by  means  of  tapes,  the  tongue  is  pressed  down- 
ward by  means  of  a  spatula  or  the  handle  of  a  spoon,  and  the  throat  is 
sprayed  by  means  of  an  atomizer  or  a  brush  or  a  quill.  The  intratracheal 
method  of  administration  of  medicinal  agents  is  rather  difficult  to  follow 
out,  particularly  in  animals  that  are  fat  or  have  short  necks;  insert  the 
needle  beneath  the  larynx  or  through  the  crico-thyroid  ligament,  the  solu- 
tions to  be  used  are  1  per  cent,  solution  of  morphine  or  codeine.  These 
injections  should  be  made  daily  or  every  other  day. 

Frequently  in  chronic  catarrh  we  use  narcotics  to  stop  the  severe 
cough  produced  by  irritation  of  the  membrane — morphine,  codeine, 
heroin,  and  in  rare  cases  bromide  of  potassium  or  chloral  hydrate. 
Expectorants  are  not  of  much  use  in  the  dog. 

As  to  other  affections  of  the  larynx,  with  the  exception  of  tuberculosis 
of  the  larynx  and  certain  tumors  described  by  Cadiot  (both  conditions 
which  are  extremely  rare),  the  only  one  of  practical  importance  is 

Hemiplegia   Laryngis. 

This  is  occasionally  observed.  In  this  affection  the  animal  has  a  pe- 
culiarly shrill  bark,  which  is  varied  in  tone,  becoming  harder  and  harsher 
and  spasmodic,  accompanied  by  great  difficulty  in  respiration,  marked 
dyspnoea  and  roaring  sounds  during  respiration.     The  condition  may  be 


W.  McDougall,  del. 


MODE   OF   ADMINISTERING    MEDICINAL   VAPORS. 


BRONCHITIS  137 

produced  by  dragging  on  a  collar,  folloAv  traumatisms,  as  in  one  case  ob- 
served, that  is,  fracture  of  the  first  rib  on  the  left  side,  and  it  is  also  seen 
following  the  pulmonary  form  of  distemper.  The  treatment  consists  of 
the  application  of  a  galvanic  battery  over  the  region  of  the  recurrent 
nerve,  the  administration  of  nux  vomica  internally,  or  of  strychnia, 
sulx'utaneouslv. 


DISEASES  OF  THE  AIR-PASSAGES  AND  BRONCHIAL  TUBES. 

Catarrh  of  the  Windpipe  and  Bronchia;  Bronchitis. 

{Trachitis  and  Bronchitis   Catarrhalis.) 

Etiology. — Catarrh  of  the  air-passages  and  of  the  bronchia  occurs 
very  fretjuently  in  young,  weakly,  or  debilitated  dogs.  It  sometimes 
originates  primarily,  but,  as  a  rule,  it  occurs  as  a  secondary  disease.  It 
is  caused  by  cold,  especially  by  breathing  cold  air  when  the  animal  is 
warm;  and  in  pet  dogs  we  see  it  cjuite  often  where  the  animals  will  lie 
near  the  register  or  an  open  fire  until  they  are  very  warm  and  then  go  to 
the  outside  door  and  lie  on  the  floor  where  the  draught  can  strike  on 
them  and  so  cool  off  very  rapidly,  and  repeat  this  a  number  of  times. 
It  is  also  caused  by  mechanical  or  chemical  irritants,  such  as  smoke, 
dust,  parasites,  strong  gases,  or,  secondarily,  from  the  extension  of  in- 
flammations from  neighboring  organs,  as  the  larynx  or  lungs,  or  from 
defective  blood  circulation  of  the  lungs,  produced  by  weakened  heart 
action.  Catarrh  of  the  trachea  and  bronchia  is  very  often  seen  as  a  com- 
plication of  distemper,  as  well  as  many  serious  internal  diseases,  especially 
in  affections  of  the  l:)rain.  The  latter  condition  is  generally  traced  to  the 
fact  that  there  is  an  accumulation  of  particles  of  food  and  secretions, 
which  collect  in  the  mouth  ami  throat,  decompose,  and  are  respired  into 
the  trachea  and  produce  an  irritation. 

There  is  no  doul)t  that  infectious  influences  play  a  certain  role  in 
the  cause  of  this  disease. 

Pathological  Anatomy. — In  describing  any  catarrh  of  the  trachea  it 
should  be  classed  under  the  head  of  bronchitis,  as  it  is  impossible  to  draw 
the  line  of  distinction  between  the  two.  In  bronchitis  the  mucous  mem- 
brane is  difi:"usely  inflamed,  swollen,  and  tears  easily  when  touched.  In 
the  ealier  stages  of  the  disease,  there  is  little  mucus  found  on  it,  but  as 
the  disease  goes  on  to  the  later  stages  the  secretion  becomes  more  copious 
and  turbid,  purulent,  and  filled  with  pus  corpuscles;  later  on  it  becomes 
more  or  less  colored  with  blood  corpuscles. 

Chronic  Catarrh. — In  this  condition,  the  color  of  the  mucous  mem- 
Ijranc  is  l^rownish-grey,  and  the  membrane  is  frequently  uneven  and 
thickened;  in  circumscribed  spots  or  covering  the  entire  membrane  the 


138  DISEASES  OF  THE  RESPIRATORY  ORGANS 

secretion  is  clammy,  slimy,  or  shining,  in  some  cases  it  is  bad-smelling  or 
even  putrid,  similar  to  atelekase. 

In  old  cases  of  chronic  bronchitis,  there  may  be  some  stenosis  of  the 
tubes,  and  also,  from  the  constant  irritation  of  the  bronchia,  emphysema 
of  the  lungs.  In  regard  to  this  the  reader  is  referred  to  works  on  patho- 
logical anatomy. 

Stenosis  (contraction)  of  the  bronchia  may  be  caused  either  by  swell- 
ing of  the  bronchial  mucous  membrane  or  by  the  collection  of  masses  of 
thickened  secretion  in  the  tulje.  In  some  cases,  the  two  causes  acting 
together  exclude  the  air  from  the  alveoli  of  that  part  of  the  lungs  to 
which  the  affected  l^ronchia  carry  the  air,  causing  the  lung-tissue 
to  collapse.  This  condition,  which  originates  in  the  manner  de- 
scribed, does  not  change  its  structure,  but  soon  becomes  solidly  filled 
with  blood. 

In  all  chronic  conditions,  we  also  find  the  opposite  of  stenosis,  that 
is,  bronchiectasis  (widening  of  the  bronchial  tubes) ;  this  is  caused  by  a 
relaxed  condition  of  the  bronchial  walls,  due  to  the  chronic  irritation  and 
also  to  the  pressure  of  collections  of  the  secretions.  This  dilatation  of 
the  tubes  may  be  either  cylindrical  or  spindle-shaped. 

Emphysema  of  the  Lungs. — This  is  found  near  the  atelectatic  centres 
and  on  the  borders  of  the  lungs;  this  condition  is  supposed  to  be  caused  by 
violent  coughing  spells  and  also  b}"  bronchitis.  The  affected  parts  do  not 
collapse,  but  appear  soft,  clear  and  bloodless;  they  will,  however,  coh 
lapse  cpiickly  on  incision. 

Clinical  Symptoms  and  Course. — These  vary,  according  to  the 
amount  and  location  of  the  irritation,  whether  it  is  in  the  trachea,  large, 
medium,  or  small  lironchia,  and  whether  it  is  acute  or  chronic. 

'1.  Acute  Catarrh  of  the  Large  Bronchia. — This  commences  with  slight 
and  frequent  chills,  accompanied  by  fatigue,  indfference,  depression,  loss 
of  appetite,  and  sometimes  with  a  stiff  and  strained  gait  and  slight  rise  of 
temperature,  which  may  rise  to  40°  C.  Soon  afterward  the  animal  com- 
mences to  cough;  this  is  one  of  the  principal  symptoms  of  the  disease.  In 
the  beginning  it  is  short,  painful  and  dry,  later  it  becomes  moist  and  more 
frequent.  It  can  easily  be  started  by  slight  pressure  on  the  trachea  and 
also  by  tapping  on  the  chest  close  behind  the  shoulder. 

Percussion,  as  a  rule,  does  not  reveal  the  full  extent  of  the  disease. 
On  auscultation,  in  mild  cases,  we  hear  an  increased  A'esicular  respiration 
in  the  trachea  and  large  bronchia,  and  when  the  medium-sized  bronchia  are 
affected  there  is  an  accumulation  of  mucus  in  the  tubes  and  the  A'csicular 
murmur  is  increased.  This  is  due  to  the  fact  that  while  the  l:)ronchitis  is 
in  the  dry  stage  the  sounds  are  roaring  or  snorting  in  character,  and  when 
the  fluid  mucus  has  accunudated  the  sounds  liecome  rattling,  as  if  the 
air  was  passing  through  a  thick  mucus  (mucous  rales.) 


BRO.XCHITIS  139 

2.  Acute  Catarrh  of  the  Smaller  Bronchia ;  Bronchitis  Capillaris ;  Bron- 
chiolitis.— When  the  small  bronchia  are  affected,  these  sounds  are  much 
more  decided,  and  in  this  condition  there  is  high  fever  and  general  disturb- 
ance of  all  the  functions,  and  also  a  marked  difficulty  in  respiration,  and 
the  disease  takes  a  much  more  serious  course,  particularly  in  young  dogs 
affected  with  distemper.  One  prominent  symptom  in  the  dog  is  the  in- 
flation of  the  cheeks  with  each  expiration.  Any  pressure  on  the  walls  of 
the  chest  will  immediately  produce  a  fit  of  coughing.  The  cough  is  first 
dull  and  weak,  and  as  the  disease  increases  it  becomes  looser  and  easier, 
the  vesicular  sounds  being  very  wheezy.  Capillary  bronchitis  in  young 
animals  is  very  apt  to  terminate  in  catarrhal  pneumonia,  but  even  if  this 
grave  complication  does  not  occur,  it  is  still  a  very  dangerous  disease  and 
is  apt  to  prove  fatal.  The  course  of  the  disease  is  never  less  than  two 
weeks,  and  may  often  last  several  weeks  before  the  animal  makes  a 
recovery. 

This  disease,  or  the  results  of  it,  is  what  is  generally  termed  asthma, 
so  often  seen  in  old,  well-cared-for  dogs.  The  disease  is  characterized  by  a 
certain  amount  of  difficulty  in  respiration,  which  is  increased  by  running 
or  ]3y  any  excitement,  and  is  generally  accompanied  by  a  severe  attack  of 
coughing,  which  in  severe  cases  ends  with  every  evidence  of  choking  or 
even  vomiting.  The  cough  is  generally  moist,  and  may  be  accompanied 
by. a  certain  amount  of  rattling.  In  the  majority  of  cases,  where  the 
disease  is  not  far  advanced,  the  animals  enjoy  good  health  and  rarely  ex- 
hibit any  fever.     In  old  cases,  the  expired  air  may  be  bad-smelling  or  f  a?tid. 

Percussion  gives  no  definite  results.  Auscultation  gives  sounds  that 
depend  on  the  number  and  size  of  the  diseased  bronchia  and  the  character 
•of  the  mucus  accumulated  in  them.  We  may  find  cither  moist  or  rat- 
tling sounds,  which  vary  in  character,  and  a  heightened  vesicular  respi- 
ration or  else  an  indistinct  mucous  sound. 

Therapeutics  of  Tracheal  and  Bronchial  Catarrh. — Keep  the  animal  in 
a  moderately  warm  ])ut  well  ventilated  place,  where  it  is  dry  and  free  from 
draughts.  In  the  early  stages  of  the  disease  give  a  mild  expectorant, 
such  as  syrup  of  tolu  or  wild  cherry.  Local  inhalation  of  vaporized  drugs 
is  not  of  much  use,  as  very  little  of  the  drug  is  carried  into  the  bronchial 
tubes,  especially  the  small  ones.  We  may  administer  medicinal  vapors  by 
putting  a  teaspoonful  of  tincture  of  benzoin,  if  the  expressed  air  is  foetid, 
or  a  weak  solution  of  creolin,  lysol,  or  carbolic  acid  in  a  quart  of  boiling 
water,  and  hold  it  so  that  the  animal  will  inhale  the  steam,  or  a  Priessnitz 
compress  may  be  put  around  the  thorax;  this  should  be  taken  off  and 
adjusted  every  three  or  four  hours. 

In  the  chronic  cases,  we  generally  get  good  results  from  the  adminis- 
tration of  expectorants,  such  as  apomorphia,  ipecacuanha,  and  spirits 
of  mindererus;  and  where  there  is  a  violent  cough,  add  narcotics,  such 


140  DISEASES  OF  THE  RESPIRATORY  ORGANS 

as  morphia,  extract  of  hyoscyamus,  or  dilute  hydrocyanic  acid  or 
cyanide  of  potassium.  When  there  is  fever  present,  a  few  doses  of  antipy- 
rine  (0.5  to  1.0  gramme,  twice  daily)  will  generally  suffice. 

Tartar  emetic,  chloride  of  ammonium,  and  sulphuretted  antimony  are 
of  little  use;  in  fact,  do  more  harm  than  good,  as  they  often  destroy  the 
appetite  and  cause  great  depression.  In  the  early  stages  of  the  disease 
the  cough  does  not  amount  to  much,  but  in  the  later  stages,  it  is  constant 
and  very  disagreeable,  especially  at  night,  and  it  is  in  such  cases  that 
expectorants  are  useful  to  remove  the  accumulations  of  mucus.  The 
addition  of  morphia  to  the  apomorphia  solution  has  the  tendency  to 
counteract  the  emetic  effects  of  the  latter  drug. 

One  important  factor  in  this  disease  is  to  keep  up  the  general  system 
by  giving  easily  digested  food  of  a  mixed  character  and  in  concentrated 
form,  and  administer  wine  or  brandy  in  small  quantities.  If  the  heart 
should  give  evidences  of  weakness,  use  stimulants,  brandy,  spirits  of  cam- 
phor, or  digitalis. 

In  chronic  bronchial  catarrh  where  a  permanent  cure  is  not  to  be  ex- 
pected, we  can  alleviate  the  sufferings  of  the  animal  by  inhalations  of 
tincture  of  benzoin  or  balsam  of  Peru,  one  teaspoonful  to  a  cup  of  boiling 
water,  or  by  means  of  the  vaporizer;  inhalations  of  medicated  vapors  are 
very  useful,  and  especially  the  vapors  of  turpentine,  where  there  is  a 
great  accumulation  of  mucus  and  a  foetid  breath.  Inhalations  of  the 
vapors  of  tar  and  creosote  are  also  useful.  The  action  of  tar  is  a  little 
irregular  and  occasionally  destroys  the  appetite.  Ichthyol  and  thiol  are 
given  in  doses  of  0.2  to  0.5  gramme  several  times  daily.  Narcotics  should 
be  administered  only  when  the  cough  is  very  severe. 

I^       Morphise  svilphatis,  0.09 

Potassii  cyanidi,  0.13 

Syr.  pruni  virginianse,  88. 0 
Sig. — One  teasijoonful  four  times  daily. 

I^.     Tine,  aconiti,  0.05 

Tine,  belladonnse,  0.03 

Tine,  bryonise,  0.02 

M.  F.  Triturat  No.  1. 

Sig. — One  tablet  three  times  daily. 

Parasitic  Bronchitis. 

The  following  parasites  produce  bronchitis;  parasitic  bronchitis,  how- 
ever, is  very  rare, 

Strongylus  Bronchialis  Canis  (Osier);  Filaria  Tracheo-bronchialis 
(Blumberg  Ral)e). — These  parasites  are  very  small  and  lodge  in  the  mu- 
cous membrane  of  the  trachea  forming  greyish-red  globular  protuberances 


CATARRHAL  IXFLAMMATIOX  OF  THE  LUXGS  141 

ranging  in  size  from  that  of  a  small  pen  to  a  coffee  Ijean  (Tracheitis  veru), 
Cosa  verminosa  (Rabe) .  These  parasites  cause  severe  coughing,  dyspnoea 
great  weakness,  fever,  vomiting,  and  colicky  pains. 

Strongylus  Vasorum  (Baillet). — These  are  long  thread-like  worms 
which  lodge  in  the  right  side  of  the  heart  and  the  pulmonary  artery.  The 
eggs  are  carried  by  the  blood  into  the  lungs,  and  lie  in  the  minute  branches 
of  the  bronchi  (bronchioles)  forming  fine  nodules  resembling  those  of 
tuberculosis;  the  embryo  is  liberated,  gets  into  the  bronchi,  causing  irrita- 
tion and  coughing,  and  the  young  parasite  is  expelled  with  the  mucus 
coughed  up,  or  some  of  the  parasites  find  their  way  into  the  alimen- 
tary tract,  then  into  the  veins,  and  are  carried  back  to  the  heart. 
Animals  afTectcd  present  the  following  symptoms:  dyspncea,  ascites,  and 
emaciation. 

The  Spiroptera  sanguinolenta  (see  page  51)  also  find  their  way  into 
the  air-passages,  causing  chronic  bronchitis. 

DISEASES  OF  THE  LUNGS. 

Catarrhal  Inflammation  of  the  Lungs;  Pneumonia. 

{Catarrhal  Pntumonia;  Lobular  Pneumonia;  Broncho-pneumonia.) 

Etiology. — Catarrhal  inflammation  of  the  lungs  generally  originates  as 
a  secondar}^  disease  following  Ijronchitis,  by  an  extension  of  the  inflamma- 
tion of  the  small  bronchia  into  the  alveoli,  or  from  the  obstruction  of  the 
bronchial  tubes;  it  may  originate  primaril}'  as  pneumonia  or  in  the  pul- 
monary form  of  distemper.  Certain  animals,  such  as  very  old  dogs,  or 
young  animals,  undeveloped  and  underfed,  as  well  as  animals  that  have 
gone  through  some  acute  illness,  are  predisposed  to  the  development  of 
lobular  pneumonia.  Lobular  pneumonia  is  caused  by  accumulations  of 
mucus  in  the  trachea  which  may  be  only  imperfectly  coughed  up,  or  in 
very  weak  cases,  lying  in  the  tubes,  become  decomposed  and  putrid,  and 
so  act  as  an  irritant.  These  particles  of  mucus  are  carried  into  the  deep 
portions  of  the  lungs,  directly  on  the  aveoli,  and  form  a  capillary  bronchi- 
tis; it  may  become  converted  into  a  catarrhal  pneumonia.  In  some  cases 
particles  of  food,  medicines,  especially  thick  mixtures,  get  into  the  lar- 
ynx when  the  animal  is  unconscious  or  where  there  is  partial  paralysis  of 
the  throat.  These  substances  penetrate  into  the  lungs  and  are  very 
difficult  to  dislodge  from  the  bronchia.  This  form  of  the  disease  is  gener- 
ally termed  traumatic  or  aspiration  pneumonia. 

Roberts  has  described  catarrhal  pneumonia  in  an  epidemic  form  at- 
tacking all  ages,  developing  a  high  temperature,  and  loss  of  30  per  cent. 
8avaresc  has  described  a  specific  pneumococcus,  but  in  all  probability 
both  observers  have  described  a  condition  similar  in  nature. 


142  DISEASES  OF  THE  RESPIRATORY  ORGANS 

Pathological  Anatomy.— In  a  lung  affected  with  catarrhal  pneumonia, 
we  always  find  all  the  characteristics  of  bronchitis,  and  as  the  disease  ad- 
vances, the  group  of  alveoli  that  belong  to  the  affected  bronchia  are 
rapidly  filled  with  the  catarrhal  deposit,  preventing  the  air  from  penetrat- 
ing into  them.  Soon  we  see  an  intense  hypersemia  of  the  walls  of  the 
alveoli  and  the  exudation  of  a  thin,  non-coagulating  fluid,  and  numerous 
white  blood  corpuscles,  which  soon  become  pus  corpuscles,  and  the  com- 
mencement of  a  fatty  degeneration  and  detachment  of  the  alveolar  cells. 
The  alveoli  and  the  small  bronchia  become  entirely  filled  with  pus  corpus- 
cles and  a  certain  number  of  blood  corpuscles  and  broken-down  epithelial 
cells,  and  the  inflamed  portion  of  the  lung  can  easily  be  distinguished 
from  its  healthy  surroundings,  forming  firm,  tough,  roundish  or  lobulatcd 
lumps,  which  vary  in  size  and  number,  projecting  slightly  above  the  sur- 
face of  the  lung,  and  on  making  a  cross-section  of  the  diseased  portions,  in 
the  earlier  stages  of  the  disease,  they  are  seen  to  be  dark  bluish-red  and 
later  on  become  gray,  while  the  surrounding  tissue  that  is  not  diseased  is 
normal  or,  what  is  more  frequent,  is  slightly  congested  with  blood.  The 
detached  centres,  which  show  plainly  in  the  early  part  of  the  disease,  soon 
become  confluent,  so  that  finally  we  find  large  sections  of  the  lung  in- 
volved. In  rare  cases  we  find  fibrinous  (croupous)  centres  in  connection 
with  the  catarrhal  pneumonic  centres  and  extended  vesicular  emphysema 
in  the  neighborhood  of  the  affected  centres,  and  at  the  borders  of  the  lungs 
it  is  often  seen.  We  may  also  have  subpleural  and  interstitial  emphy- 
sema and  sero-fibrinous  or  pussy  pleuritis  about  the  broncho-pneumonic 
centres. 

Clinical  Symptoms. — It  is  very  difficult  to  make  a  sharp  distinction 
between  capillary  bronchitis  and  lobular  pneumonia  on  account  of  the 
close  relation  between  these  two  diseases.  If  the  disease  has  affected  the 
alveoli,  there  is  a  marked  acceleration  of  the  respirations,  in  some  cases  as 
high  as  60  per  minute,  and  also  inflation  of  the  cheeks  with  each  expira- 
tion; the  cough  is  short,  frequent,  and  apparently  very  painful,  the  pulse 
running  from  150  to  170,  temperature  rises  quickly  and  remains  high. 
On  making  a  physical  examination  by  percussion,  there  are  a  number  of 
dull  centres  though  the  lungs;  in  some  instances  the  whole  of  the  lung 
gives  dull  sounds  on  auscultation.  According  to  the  stage  of  the  disease, 
we  hear  rales  of  various  characters,  strong  vesicular  breathing,  snoring,  fine 
or  loud  bruits,  and  where  there  is  extended  infiltration,  we  hear  bronchial 
respiration  and  certain  spots  where  there  is  no  respiratory  murmur  at  all. 

The  temperature  often  goes  up  to  40°  or  41°;  this  high  temperature 
usually  commences  early  in  the  disease  or  it  often  makes  a  rise  when  the 
disease  has  become  converted  into  catarrhal  pneumonia.  If  this  compli- 
cation does  not  occur,  the  temperature  will  not  make  any  marked  change, 
but  will  follow  a  regular  course,  which  is  to  rise  quickly  at  the  onset 


CHRONIC  INTERSTITIAL  PNEUMONIA  143 

and  gradually  fall  as  the  disease  decreases  and  the  animal  goes  on  to 
convalescenre. 

Course  and  Prognosis. — The  course  of  catarrhal  inflammation  of  the 
lungs  is  rarely  less  than  three  weeks,  and  is  often  prolonged  over  three 
months,  with  varying  degrees  of  intensity.  Traumatic  pneumonia  is  the 
only  form  of  the  disease  that  runs  its  course  quickly. 

The  evidences  of  termination  of  the  disease  arc:  Recovery  by 
resolution,  in  which  the  inflammatory  products,  which  fill  the  smallest 
l)i'onchia  and  the  alveoli,  are  changed  into  a  form  of  emulsion  and  are 
either  reabsorbed  or  coughed  up,  or  develop  into  a  secondary  disease, 
for  instance,  chronic  interstitial  inflammation  of  the  lung  or,  in  rare  cases, 
the  formation  of  purulent  gangrenous  centres.  Third,  death,  which  may 
occur  at  any  stage  of  the  disease;  in  the  early  stages,  as  a  conseciuence 
of  great  extension  of  lobular  pneumonia  or  at  any  time  as  a  result  of 
cedema  of  the  lungs,  this  is  observed  in  very  young  animals  that  are 
very  weak,  particularly  in  the  pulmonarj'  form  of  distemper,  but  it  may 
also  occur  in  very  old  debilitated  animals.  Traumatic  pneumonia,  if 
it  is  acute,  generally  results  fatally  and  little  or  nothing  can  be  done 
to  produce  a  favorable  result. 

Chronic  Interstitial  Pneumonia. 

{Chronic  Induration  of  the  Lungs;  Cirrhosis  of  ihe  Lungs;  Phthisis.) 

When  the  disease  terminates  in  this  pathological  condition  we  find 
an  inflammatory  deposit  in  the  interlobular  and  interstitial  connective 
tissue.  This  deposit  compresses  the  alveoli  and  small  bronchia,  and 
they  lose  their  functions  and  are  finally  absorbed,  and  on  section  of  the 
affected  portion  of  the  lung  it  is  found  to  be  coarse,  rough,  and  irregu- 
lar on  its  surface,  the  tissue  varying  from  yellow  to  yellowish-red  in 
color  and  the  lobules  surrounded  by  connective  tissue.  The  bronchia 
surrounding  the  affected  portion  are  distended  and  pocket-shaped, 
and  there  are  also  a  certain  number  of  spots  of  localized  emphysema. 

The  clinical  course  of  the  disease  shows  very  little  fever,  but  the 
animal  is  never  entirely  restored  to  health;  the  respirations  are  short, 
labored,  and  with  a  quick,  weak  cough.  The  affected  animal  becomes 
emaciated,  the  condition  is  complicated  wdth  dropsical  effusions,  and  it 
finally  dies  from  exhaustion. 

In  some  cases  of  lobular  inflammation  of  the  lungs  the  inflamed 
portions  form  abscesses,  or  we  may  find  portions  of  the  lung  that  are 
gangrenous.  These  terminations  depend  on  the  nature  of  the  irritant, 
and  generally  occur  after  traumatic  pneumonia  (foreign  bodies).  A^  hen 
suppuration  commences  in  the  alveoli,  an  abscess  is  formed  and  a  pear- 
shaped  body  is  found  in  the  centre  of  the  infiltrated  lobule,  and  sur- 


144  DISEASES  OF  THE  RESPIRATORY  ORGANS 

roundino;  it  is  a  thin,  delicate  layer  of  yellowish  tissue  and  over  that 
a  tough  layer  of  red  inflamed  fibrous  tissue;  large  abscesses  may  be 
formed  by  the  fusion  of  all  the  infiltrated  pulmonary  tissue. 

When  gangrene  has  developed,  the  inflamed  catarrhal  centre  be- 
comes dirty  greenish-brown  in  color,  or  in  severe  cases,  almost  black. 
In  the  early  stages  the  diseased  portion  is  hard  and  fibrous,  l)ut  it 
soon  becomes  soft  and  pulpy  and  filled  with  a  turbid,  foetid,  greenish 
serum.  When  the  disease  is  slow  and  chronic,  the  gangrenous  spots  are 
limited  in  size,  but  generally  when  the  disease  assumes  the  gangrenous 
form,  it  becomes  diffuse  and  the  animal  dies  rapidly  from  exhaustion. 

We  recognize  the  gangrenous  form  when  the  breath  becomes  pu- 
trid, for  in  the  dog  it  is  almost  impossil^le  to  get  any  of  the  discharge  that 
is  coughed  up,  the  animal  generally  swallowing  the  mucus.  Ausculta- 
tion of  the  lungs  may  detect  tympanic  or  metallic  sounds,  mucous  rales 
and  increased  bronchial  sounds.  When  gangrene  (necrotic  pneumonia) 
has  developed,  the  animal  has  a  putrid  breath  and  a  series  of  alarming 
symptoms  accompanying  it — septic  fever,  chills,  and  a  high  tempera- 
ture, with  weak,  irregular  pulse.  If  the  sputa  were  examined,  we  would 
probaf)ly  find  numerous  micrococci,  bacteria,  and  portions  of  broken- 
down  lung-tissue. 

(Edema  of  the  Lungs. — This  is  apt  to  follow  not  only  pneumonia, 
but  all  debilitating  diseases  that  weaken  the  left  side  of  the  heart,  and 
that  organ  is  unable  to  force  the  venous  blood  through  the  lungs.  There 
is  a  regurgitation  of  the  blood,  and  the  alveoli  and  bronchia  become  filled 
by  a  serous  fluid  which  exudes  from  the  blood  vessels.  The  cedematous 
lung  is  distended  and  much  larger  than  normal;  on  pressure  with  the 
finger  the  indentation  remains  some  time.  On  section  of  the  lung,  a 
large  quantity  of  reddish  foamy  fluid  exudes  from  the  tissues  and  the 
bronchial  tulles. 

When  oedema  of  the  lungs  follows  catarrhal  pneumonia  it  gener- 
ally begins  with  great  difficulty  in  respiration,  labored  or  stertorous  in 
character,  a  short,  faint  cough,  and  in  rare  instances  a  quantity  of  thin 
reddish  fluid  comes  from  the  nose  or  mouth.  On  making  a  physical 
examination,  percussion  gives  no  results  but  those  found  in  catarrhal 
pneumonia.  On  auscultation,  we  hear  rattling  bruits  all  over  the  chest, 
especially  in  the  anterior  part,  and  also  in  the  trachea;  the  blowing  sounds 
may  be  very  loud  in  some  cases,  and  can  be  heard  some  distance  from 
the  animal.  Death  occurs  in  a  short  time.  Some  time  before  the  ac- 
tual symptoms  of  oedema  appear,  the  exhausted  condition  of  the  heart 
is  indicated  by  the  pulse  being  irregular,  that  is,  weaker  at  inspiration 
than  at  expiration. 

Therapeutics. — In  treating  l()l)ular  ])neumonia  we  follow  the  same 
eeneral    course    as  we  (,lo  in  broncliitis.     Ihc  writer  obtained  the  best 


CHROXIC  INTERSTITIAL  PNEUMONIA  145 

results  with  Priessnitz's  compress  and  from  the  remedies  recommended 
under  the  treatment  for  bronchitis.  The  good  effects  of  moist,  warm 
compresses  can  be  much  increased  by  sharp  friction  with  a  small  cjuan- 
tity  of  mustard  oil  to  the  sides  but  it  must  be  applied  only  in  young, 
strong,  healthy  animals.  The  best  method  of  application  is  to  make  a 
liniment  of  3  parts  of  oleum  sinapis  aethereum  in  45  parts  of  olive  oil  and 
divide  it  into  2  parts  and  apply  one-half  to  each  side  of  the  chest  then 
wind  a  dry  bandage  around  the  chest  walls  and  ten  to  twelve  hours  later 
apply  Priessnitz's  compress.  Narcotics  are  to  be  given  when  the  cough 
is  constant  and  distressing.  Where  there  is  much  debility  stimulants 
such  as  wine  or  ether  are  indicated  and  the  animal  should  be  given  small, 
often-repeated  quantities  of  chopped  meat,  juice  of  meat  pressed  from 
raw    beef,  broth,  milk,  and  the  peptone  preparations. 

Some  good  is  to  be  derived  from  inhalations  in  this  disease.  When 
the  breath  is  offensive  we  advise  inhalations  of  benzoin,  4.0  to  cup  of 
boiling  water.  Inhalations  of  creosote  are  recommended,  but  on  account 
of  the  danger  of  absorption  and  irritation  of  the  kidneys  by  that  drug 
they  are  to  be  used  with  extreme  caution.  In  septic  fever,  after  the 
appearance  of  gangrene  of  the  lungs,  give  subcutaneous  injections  of 
ether  or  camphor. 

When  oedema  of  the  lung  is  recognized,  it  must  be  regarded  as  a 
grave  symptom  for  it  is  generally  fatal.  We  must,  therefore,  take  very 
energetic  measures — active  stimulants,  such  as  mustard  oil  to  the  sides, 
and  also  injections  of  ether  or  camphor  subcutaneously.  Bleeding  and 
the  use  of  cardiac  stimulants,  such  as  digitalis  or  caffeine,  are  useless. 

Other  Diseases  of  the  Lungs. 

Catarrhal  pneumonia  is  the  only  important  disease  of  the  lungs  in 
the  dog;  the  others  which  are  here  described  are  of  small  importance 
and  rarely  seen. 

Congestion  of  the  Lungs,  Acute  Hyperaemia  of  the  Lungs. — This  dis- 
ease is  comparatively  rare,  generally  being  observed  in  the  summer,  as  a 
result  of  very  severe  exercise;  for  example,  in  hunting  dogs,  in  warm 
weather,  or  animals  running  after  cars,  wagons,  or  bicycles  until  ex- 
hausted, or  as  a  result  of  infiltration  of  the  lung  in  ascites,  or  from  cold 
air,  gas,  great  heat  or  smoke  if  the  animal  has  been  in  a  burning  house 
or  kennel,  etc. 

The  early  acute  symptoms  are  greatly  accelerated  respiration, 
mouth  open,  tongue  deep  blue  to  purple  and  hanging  out,  animal  restless 
and  excited,  heart  full,  bounding,  and  easily  felt  through  the  chest  wall, 
hard  full  pulse,  cyanosed  mucous  membranes,  and  if  the  acute  condition 
continues  for  any  length  of  time,  apoplectic  cedema,  apoplexy,  or 
10 


146  DISEASES  OF  THE  RESPIRATORY  ORGANS 

acute  pulmonary  hemorrhage  follows  and  death  occurs  in  a  very  short 
time. 

Therapeutics. — Keep  the  animal  in  the  air  or  a  well  ventilated  room 
and  let  the  animal  rest,  with  no  disturbing  influences.  In  grave  cases  use 
venesection,  cold  baths  and  clysters,  or  massage  of  skin.  If  oedema 
threathens,  treat  accordingly. 

Croupous  Inflammation  of  the  Lungs ;  Fibrinous  Pneumonia. — This 
is  a  firm,  hemorrhagic  exudation  in  the  alveoli  of  the  lungs  and  small 
bronchia.  Is  very  rarely  seen  in  the  dog.  The  writer  has  never  seen  a 
case  of  true  lol)ular  pneumonia,  but  has  seen  a  few  cases  of  croupal 
lobular  pneumonia,  the  course  of  which  is  very  similar  to  that  of  catarrhal 
pneumonia  in  all  its  symptoms,  the  difference  being  detected  only  on 
post-mortem.  Roll  makes  the  statement  that  croupous  inflammation  of 
the  lungs  is  common  in  the  dog,  but  he  probably  meant  croupal  lolnilar 
pneumonia. 

The  clinical  difference  between  croupal  and  catarrhal  pneumonia 
is  the  rapid  course  in  the  onset  of  the  former,  the  bronchial  murmur 
is  lost  early,  due  to  the  filling  up  of  the  bronchial  tulies,  the  frequent 
complication  of  pleurisy  and  the  quick  formation  of  a  pleuritic  exudate. 

Anthracosis  pulmonum  (blackening  of  the  lungs),  due  to  the  inhala- 
tion of  coal  dust  or  coloring  matter  found  in  animals  living  in  cities  or 
kept  as  watch  dogs  in  factories  where  dust  is  constantly  in  the  atmos- 
phere, is  quite  common  in  the  dog,  but  it  has  no  pathological  significance. 

Emphysema  of  the  lungs  is  not  such  an  important  disease  in  the  dog 
as  it  is  in  man  and  the  horse.  That  form  of  emphysema  which  appears 
in  bronchitis  and  pneumonia,  characterized  by  an  extreme  distention  of 
the  alveoli,  has  been  mentioned  under  these  diseases.  If  the  irritation  is 
constant,  the  disease  becomes  chronic  and  a  progressive  atrophy  of  the 
alveolar  walls  takes  place  until  they  are  entirely  closed  up,  the  neighbor- 
ing alveoli  become  absorbed  or  altered,  and  finally  large  cavities  are 
formed,  and  the  blood  vessels  become  atrophied.  On  section  of  the  lung 
the  edges  of  the  cavities  are  pale,  soft,  and  the  blood  vessels  are  stained 
with  pigment.  Sometimes,  as  a  result  of  severe  exertion,  such  as 
vomiting,  pregnancy,  or  laceration  of  the  alveolar  walls,  air  is  allowed  to 
penetrate  into  the  interlobular,  interstitial,  or  subpleural  connective 
tissue;  this  is  generally  caused  as  a  result  of  severe  and  continual  cough- 
ing spells  and  where  animals  have  died  from  some  form  of  suffocation. 
Siedamgrotzky  describes  a  case  where  an  old  emphysematous  dog  had  a 
severe  fit  of  coughing  and  the  lung  was  lacerated,  causing  pneumothorax. 

Bronchial  Asthma;  Asthma. — Under  tlie  general  term  of  asthma 
we  understand  dyspnoeas,  accompanied  with  continued  cough  and  labored 
spasmodic  breathing.  The  true  spasmodic  asthma,  as  described  in  man, 
in  which  there  are  acute  attacks  of  spasmodic  respiration,  can  hardly  be 


DISEASES  OF  THE  PLEURA;  PLEURISY  147 

said  to  occur  in  the  tlog.  Temporary  dyspna?a  occurs  in  heart  disease, 
nephritis,  and  some  other  affections.  In  a  general  sense,  asthma  or 
bronchial  asthma,  as  we  designate  the  disease  in  man,  is  characterized 
by  attacks  of  acute  dyspnoea  at  irregular  intervals,  caused  by  temporary 
spasmodic  contraction  of  the  bronchi.  While  it  was  once  generally 
thought  that  asthma  was  a  pure  neurosis  (bronchiale  neurosum),  the 
inclination  of  the  present  clay  is  to  believe  that  in  the  majority  of  cases 
reflex  action  from  the  nasal  mucous  membrane  is  one  of  the  chief  causes. 
The  attack  generally  begins  by  constant  sneezing  and  drawing  inhala- 
tion with  great  effort  as  if  the  nose  was  entirely  filled;  o-are  must  be  taken 
not  to  confuse  this  condition  with  congestion  of  the  turbinated  bones  or 
nasal  polypus. 

Neo -formations  of  the  Lung. — "With  the  exception  of  tubercular 
alterations,  changes  in  the  lungs  are  exceeding  rare.  Carcinomas  may 
occur,  generally  associated  with  carcinoma  of  the  thyroid  or  the  mammary 
glands;  these  appear  in  varying  sized  nodules  in  the  lung  tissue;  those  at- 
tached to  cartilaginous  layers  of  the  bronchi  grow  to  quite  a  large  size. 
The  clinical  symptoms  in  the  early  stages  of  these  formations  are  not  very 
pronounced  and  rarely  observed,  but  may  present  symptoms  similar 
to  chronic  affections  of  the  lungs,  such  as  chronic  bronchitis  or  interstitial 
pneumonia.  There  may  be  difficulty  in  respiration,  oedema  of  the  head 
and  neck,  due  to  pressure  on  the  jugular.  Frohner  found  one  case  of 
carcinoma  of  the  lungs  where  the  animal  had  frequent  hemorrhage. 
Treatment  is  useless.  Parascandolo,  keeping  up  artificial  respiration, 
removed  a  carcinoma  through  the  chest  wall  from  a  large  dog. 

DISEASES  OF  THE  PLEURA. 

Inflammation  of  the  Pleura;  Pleurisy. 

{Pleuritis.) 

Etiology. — The  disease  is  divided  into  two  forms — primary  and 
secondary  pleuritis.  The  primary  form  may  be  caused  by  cold;  it  may 
also  occur  as  a  metastasis,  or  from  the  presence  of  certain  bacteria  in  the 
l^lood,  which  find  a  favorable  nidus  in  the  pleura,  lodge  there  and  set  up 
pleuritis.  The  secondary  form  results  from  traumatic  causes,  such  as  an- 
imal being  kicked,  stepped  on,  or  receiving  a  violent  blow  on  the  thorax, 
from  the  extension  of  inflammations  from  the  surrounding  organs,  as 
gangrenous  pneumonia,  pericarditis,  or  from  peritonitis  extendmg 
through  the  diaphragm,  fractured  ribs,  injuries  to  the  walls  of  the  thorax, 
or  perforation  of  the  throat  by  foreign  bodies.  We  also  see  it  in  all  forms 
of  pytemia  and  tuberculosis.  Cadeac  thinks  that  in  nine  out  of  ten  cases  of 
septicaemia  following  serous  or  fibrous  pleuritis  in  the  dog,  it  is  of  tuber- 


148  DISEASES  OF  THE  RESPIRATORY  ORGANS 

cular  origin.  Tumors  of  the  pleura,  chronic  nephritis,  and  acute  articuhir 
rheumatism  may  also  develop  pleurisy.  Piana  found  bacilli  and 
Hutyra  and  Marek  found  it  caused  by  streptothrix  (actinomyces)  canis. 

Pathological  Anatomy. — The  exudation  which  collects  rapidly 
crowds  the  lung  of  the  affected  side  and  finally  presses  it  against  the  spinal 
column  and  mediastinum,  pressing  the  lung  into  an  inert  mass  (lung 
atelectasis).  The  opposite  lung  is  the  seat  of  considerable  collateral 
hyperaemia,  which  ma}^  lead  to  oedema,  according  to  the  severity  of  the 
condition.  When  compression  of  a  lung  is  continued  for  any  length  of 
time,  the  alveoli  lose  their  functional  activity,  their  walls  collapse  and 
become  adherent  even  if  the  fluid  exuded  finally  becomes  absorbed. 
After  this  has  occurred,  it  can  readily  be  recognized  by  the  depressed 
appearance  of  the  ribs.  In  cases  of  primary  pleuritis  which  have  been 
seen  by  the  writer,  the  inflammatory  process  was  always  restricted  to  one 
side,  and  that,  as  a  rule,  was  the  left  side.  The  cases  of  secondary  pleuritis 
were  generally  double-sided,  but  the  inflammatory  conditions  are  never 
of  equal  intensity  on  both  sides,  one  side  being  always  a  little  worse  than 
the  other.  Besides  having  the  results  of  pressure  shown  on  the  lungs,  we 
also  find  the  heart  is  pushed  toward  the  healthy  side  of  the  mediastinum 
or  the  diaphragm. 

The  conclusion  of  pleuritic  inflammation  depends  on  the  intensity 
and  duration  of  the  disease  and  the  character  of  the  exudate.  In  favor- 
able cases  the  latter  is  reabsorbed  and  good  results  follow.  In  serious 
cases,  only  part  of  the  liquid  portion  of  the  exudate  is  absorbed,  while  a 
fibrinous  exudate  covers  the  pleura;  this  becomes  converted  into  a  granu- 
lar tissue  containing  numerous  vessels  and  later  into  a  stringy  cicatricial 
tissue,  called  a  pleuritic  sward,  with  more  or  less  adhesions  of  the  pleura 
between  the  lungs  and  inner  wall  of  the  thorax  and  between  the  lungs  and 
diaphragm.  Although  the  sward  formations  may  be  very  extensive,  it 
is  possible  for  the  lung  to  regain  its  normal  extension,  but  this  takes  a 
long  time.  Thin  adhesions  sometimes  tear;  and  extended  adhesions  offer 
a  constant  hindrance  to  the  unrestricted  use  of  the  affected  part  of  the 
lung.  Purulent  exudates  are  sometimes  reabsorbed;  but,  as  a  rule,  if  the 
pus  is  not  removed  at  the  proper  time  by  surgical  interference  it  breaks 
out,  either  through  the  pleura  into  the  lungs  and  then  through  the  bron- 
chia, or  it  forms  an  abscess  somewhere  in  the  cavity  of  the  chest,  generally 
in  the  region  of  the  sternum,  by  undermining  the  pleura  and  muscles  of 
the  chest. 

Clinical  Symptoms. — In  the  primary  form  of  pleuritis,  when  its 
origin  is  from  cold,  etc.,  it  is  ushered  in  with  a  rapid  rise  in  temperature, 
the  pulse  increases  in  frequency,  and  at  the  onset  the  animal  generally 
has  a  chill;  the  temperature  remains  high,  and  the  pulse  is  small,  weak, 
and  thready.     Primary  pleuritis  with  purulent  or  putrid  effusions  is  rare, 


DISEASES  OF  THE  PLEURA;  PLEURISY  149 

and  when  it  does  occur  it  is  always  accompanied  by  a  high  remittent 
fever. 

The  general  health  is  very  much  disturbed.  The  animal  Is  stiff 
and  sore  on  moving  about;  has  little  or  no  appetite,  but  intense  thirst. 
The  visil^le  mucous  membranes  are  reddened  and  congested,  and  in  cases 
where  there  is  much  exudation,  the  membranes  are  dark  bluish-red. 
The  faeces  are  dry  and  hard.  The  urine  presents  some  symptoms  that 
are  diagnostic;  for  instance,  while  the  exudate  is  forming  and  collecting, 
the  urine  is  scanty  and  thick  and  albuminous  in  reaction.  When  the 
exudate  is  commencing  to  be  reabsorbed  the  urine  increases  very  much 
in  quantity  and  is  very  clear  or  whitish-yellow  (see  chapter  on  Examina- 
tion of  the  Urine). 

There  is  also  marked  dyspnoea.  In  dry  pleuritis  the  respiration  is 
superficial  and  rapid,  and  where  there  is  great  exudation  the  respirations 
are  short  and  painful  and  the  animal  has  all  the  symptoms  of  smothering. 
A  characteristic  symptom  is  the  way  the  animal  endeavors  to  assist 
respiration  by  assuming  a  sitting  position  with  the  front  legs  spread  out 
as  far  apart  as  possible  and  using  the  abdominal  muscles,  with  show  of 
pain  on  pressure  of  the  abdominal  muscles  of  the  affected  side.  The 
animal  has  a  soft,  dry,  weak  cough;  this  may,  however,  be  absent. 

The  physical  symptoms  are  characteristic.  On  percussion  at  the 
onset  of  the  disease  there  is  little  change  of  sound,  but  when  the  exudate 
has  reached  a  certain  height,  the  lower  parts  of  the  chest  give  a  dull 
sound  which  seems  to  be  limited  in  a  straight  line,  according  to  the  posi- 
tion of  the  animal.  Above  the  exudation  the  sound  is  tympanitic  on 
account  of  the  retraction  of  the  lung.  Auscultation  gives  a  friction  bruit 
in  the  onset,  and  when  the  fluid  begins  to  be  reabsorbed  and  the  pressure 
of  the  exudate  against  the  lungs  is  lessened,  the  respiratory  bruit  is 
altered.  In  the  earliest  stages  of  the  disease  the  sounds  are  vesicular, 
but  as  the  exudate  collects  the  sounds  become  indistinct  or  blowing  and 
finally  only  bronchial,  and  when  the  bronchial  tubes  are  affected  the 
sound  is  lost  entirely.  In  the  healthier  parts  of  the  lungs  we  find  in- 
creased vesicular  breathing. 

Course  and  Prognosis. — Primary  pleuritis  is  generally  slow  in  its 
course;  the  time  taken  by  the  exudate  to  become  reabsorbed  is  very  long, 
except  in  very  young  animals,  unless  it  is  removed  in  an  operative  way. 
When  the  exudate  commences  to  be  reabsorbed  the  percussion  sound 
becomes  less  dull  and  the  respiration  bruit  more  distinct,  and  if  the  exu- 
date becomes  quickly  reabsorbed,  the  diseased  side  is  lessened  in  cir- 
cumference, or  it  can  be  better  described  as  being  flatter. 

Death  may  occur  during  the  critical  period  of  the  disease  by  col- 
lateral hypera^mia  and  cedema  of  the  non-affected  sections  of  the  lungs, 
by   carbon-dioxide  poisoning,  from  defective  function  of  the  lungs,  by 


150  DISEASES  OF  THE  RESPIRATORY  ORGANS 

total  stagnation  of  the  circulation  of  the  blood,  from  pressure  of  the 
exudate  on  the  large  blood  vessels  and  the  heart,  or  later  on  ljy  exhaus- 
tion and  by  seconclary  diseases.  To  this  class  belong  dropsy  caused  l)y 
stagnation  of  the  blood  circulation,  from  weakness  of  the  heart,  and  amy- 
loid degeneration  of  the  kidneys,  liver,  or  spleen.  Death  may  also  occur 
from  complicating  diseases,  such  as  bronchitis  and  lobular  pneumonia. 

The  prognosis  is  generally  favorable;  as  a  rule,  very  severe  cases  of 
primary  pleuritis  make  good  recoveries,  depending  largely  on  the  aninud 
and  character  of  the  exudate  and  the  realworption  of  the  lymph,  and  there 
may  at  times  be  adhesion  of  the  whole  or  part  of  the  pleuritic  surfaces. 
In  secondary  pleuritis  the  prognosis  depends  on  the  original  disease. 

Therapeutics. — The  treatment  of  secondary  pleuritis  is  the  same  as 
the  primar}',  but  in  the  former  we  must  take  into  consideration  the  treat- 
ment of  the  original  disease.  In  the  early  stages  of  the  disease,  when 
the  exudate  is  collecting,  we  must  apply  counter-irritants,  such  as  lini- 
ments or  plasters  of  mustard.  When  a  copious  exudate  has  been  formed 
we  try  to  induce  its  real^sorption  by  stimulating  the  kidneys  by  means 
of  acetate  of  potassium,  acetate  of  sodium,  with  the  Priessnitz  compress. 
When  the  heart  is  weak  we  use  digitalis  and  sciuiils.  Small  doses  of 
calomel  are  also  useful. 

1^.     Hydrarg.  chlor.  mitis,  0.03 

Digitalis  pulv.,  '        0.05 

8accharum  lactis,  0.5 

M.  et  fiat  pulv.  No.  vi. 

Sig. — One  i^owder  three  times  daily. 

Diuretics  and  cardiac  stimulants  have  only  an  indirect  influence  on 
the  accumulations,  and  when  the  exudate  is  gradually  absorbed  one  can 
hardly  credit  these  drugs  with  accomplishing  the  results,  as  the  exudate 
is  usually  reabsorbed,  w^hen  the  acute  inflammatory  stage  of  the  disease 
has  passed.  The  best  method  of  treatment  is  the  removal  of  the  secretion 
by  surgical  means,  that  is,  by  puncturing  the  chest  wall.  This  operation 
is  not  at  all  dangerous  in  the  dog,  and  is  generally  sucessful,  unless  the  ad- 
hesions are  too  thick. 

The  operation  must  be  performed  where  there  is  a  very  large  exudate 
and  the  dull  sound  can  be  heard  over  the  entire  lung,  that  is,  where  there 
is  oedema  of  the  lung  and  intense  dyspnoea  caused  by  the  pressure  of 
the  exudate;  or  where  there  is  deficient  reabsorption  as  is  seen  where 
the  fever  has  entirely  disappeared  and  the  fluid  does  not  show  any  signs 
of  becoming  real^sorbed. 

Puncture  of  the  Cavity  of  the  Chest. — This  must  be  on  the  side 
where  the  exudate;   is   higliest;   this  can   be  detected  by  auscultation. 

The  trocar  used  in  this  opei'ation  is  an  ordinary  sized  trocar,  seen 
in  Fig.  65,  or,  if  we  wish  to  make  first  an  exploring  punctvire,  we  use  the 


DROPSY  OF  THE  CHEST 


151 


needle  of  the  ordinary  hypodermatic  syringe.     The  needle,  after  having 

been  disinfected,  is  introduced  into  the  lower  third  of  the  wall  of  the  chest,  in 

any  of  the  interspaces  between  the  fifth  and  ninth  riljs,  the  patient  being  in  a 

standing  position  or  laid  on  a  table  and  held  by  means  of  an  assistant.    The 

entrance  of  air  into  the  thoracic  cavity  must  be  avoided,  and  to  prevent 

this  we  must  use  a  trocar  that  has  a  faucet,  or  else 

Avhere  we  use  the  ordinary  trocar  and  canula  when 

the  flow  of  the  fluid  becomes  stopped  at  any  time 

from  some  obstruction  at  the  end  of  the  trocar,  it  is 

well  to  put  the  finger  over  the  end  of  the  opening 

to  prevent  the  air  from  being  sucked  into  the  cavity. 

When  the  animal  coughs  violently  the  trocar  must 

be  withdrawn  or  the  finger  kept  on  the  opening  of 

the  trocar  or  when  the  fluid  becomes  bloody  or  the 

point  of  the  trocar  is   felt   resting  on   the    pleura. 

It  is  well   to   empty  the   cavity  slowly  and   never 

entirely,  as  the  two  faces  of  affected  pleurae  coming 

in  contact  with  each  other  and  rubbing  often  causes 

acvite    hemorrhage.      After  withdrawing  the  trocar 

it  is  well  to  paint  the  opening  with  some   iodoform   fig.  65.— Trocars  for  punL- 

collodion.  t"""*^  «^  ^^^  ^^°''=^^- 

When  the  fiuid  obtained  is  purulent,  it  generally  requires  several 
punctures  to  empty  the  cavity.  The  animal  should  have  a  nutritive 
but  easily  digested  diet — soup,  beef  tea,  or  lean  meat,  and  when  the  fever 
is  high,  antijoyrine  in  doses  of  0.5  to  2.0,  according  to  the  size  of  the  dog. 


Dropsy  of  the  Chest. 

(Hydrothorax.) 

Any  accumulation  of  serous  fluid  that  is  not  dependent  on  an  in- 
flammation of  the  pleura  (that  is,  of  a  transudate)  in  the  cavity  of  the 
thorax,  is  called  hydrothorax.  This  is  often  a  symptom  of  general  dropsy 
or  it  may  arise  from  chronic  disease  of  any  of  the  organs  (see  ascites). 
In  such  cases  the  effusion  first  shows  itself  in  the  chest  when  dropsy  of 
the  skin  (anasarca)  exists,  or  as  a  result  of  disturbance  of  the  venous 
system,  particularly  of  the  portal. 

Pathological  Anatomy. — Hydrothorax,  as  a  rule,  affects  both  sides 
of  the  chest,  Frohner  records  a  case  where  one  side  only  was  affected. 
We  find  in  the  cavity  of  the  chest,  a  clear  j^ellow  fluid,  sometimes  stained 
with  blood  and  distinguished  from  a  pleuritic  exudate  by  the  absence 
of  fibrin,  very  little  cellular  elements,  little  albumen,  and  by  a  low 
specific  gravity.  The  pleura  is  oedematous  and  swollen,  and  in  long- 
continued  cases  it  has  a  flaccid  or  macerated  look.     The  lungs  do  not 


152  DISEASES  OF  THE  RESPIRATORY  ORGANS 

present  any  change  except  the  signs  of  jDartial  compression.  The  other 
organs  of  the  body  are  aneemic. 

Clinical  Symptoms. — The  physical  examination  of  this  disease  pre- 
sents symptoms  ver}-  similar  to  pleuritic  exudates,  but  the  change  takes 
place  quickly,  and  fever  and  cough  are  absent,  but  in  dropsical  transudates 
both  sides  of  the  thoracic  cavity  are  filled,  and  on  changing  the  position 
of  the  animal  the  fluid  moves  about  much  more  quickly  than  a  pleuritic 
exudate  would,  and  the  sensitiveness  of  the  animal  to  pressvire  on  the 
Avails  of  the  chest  and  the  rubbing  or  crepitating  bruit  of  pleuritis  is 
absent. 

Therapeutics. — The  treatment,  as  a  rule,  is  of  a  palliative  character, 
as  it  is  only  in  very  rare  instances  that  we  succeed  in  removing  the 
original  disease;  but  we  may  use  the  same  agents  as  in  ascites.  The  op- 
eration of  tapping  the  chest  wall  (see  puncture  of  the  cavity  of  the  chest, 
page  150)  is  only  to  be  resorted  to  when  the  fluid  has  collected  in  large 
quantities  and  the  animal  is  threatened  with  suffocation;  but  this  only 
affords  temporary  relief. 

Other  Diseases  of  the  Pleura. 

Pneumothorax. — Etiology. — The  cause  of  pneumothorax,  that  is  to 
say,  the  accumulation  of  air  in  the  thorax,  is  produced  in  several  ways; 
by  perforating  wounds  of  the  chest,  by  the  breaking  into  the  pleural 
cavity  of  a  collection  of  pus  from  the  lung,  by  tearing  of  the  lung  tissue 
from  great  exertion,  and  from  perforation  of  the  oesophagus  or  pharynx. 
Careless  puncture  of  the  chest  wall,  fracture  of  ribs,  perforation  of  the 
bronchi  by  a  foreign  body,  which  finds  its  way  into  that  part,  or  it  may 
also  be  caused  by  degeneration  of  the  pleuritic  effusion,  causing  the  for- 
mation of  gas. 

Pathological  Anatomy. — On  making  an  opening  into  the  chest  with 
trocar  and  canula,  the  air  escapes  with  a  hissing  sound;  if  the  collection  of 
air  is  great,  the  lungs  are  pushed  out  of  position,  interfering  greatly  with 
respiration.  If  this  condition  exists  for  any  length  of  time,  a  purulent, 
and,  in  rare  cases,  a  sero-purulent,  pleuritis  is  developed,  caused  by  the 
presence  of  some  irritant  agents  that  have  gained  admittance  into  the 
cavity  besides  air. 

Clinical  Symptoms  and  Course. — There  is  great  difficulty  in  respira- 
tion, and  the  affected  side  of  the  chest  wall  is  visibly  distended,  and  during 
respiration  it  remains  almost  stationary.  When  the  heart  is  pushed  out 
of  position  there  is  a  peculiar  tympanitic  sound,  the  pulsations  have  a 
metallic  echo,  and  the  respiratory  bruit  is  absent.  In  some  rare  cases 
we  hear  a  metallic  bruit;  this  is  caused  by  the  entrance  of  air  directly 
into  the  pleural  cavity  with  each  inspiration. 


PNEUMOTHORAX  153 

Animals  in  this  condition  generally  die  rapidly,  although  we  may 
find  rare  cases  where  recovery  takes  place  by  an  absorption  of  the  air,  or 
is  followed  by  the  accumulation  of  a  fluid  (pneumohydrothorax)  which 
itself  in  turn  becomes  rapidly  absorbed.  The  treatment  consists  in  the 
administration  of  camphor  or  alcoholic  stimulants  and  in  tapping  the 
chest  wall. 

Hematothorax. — In  consequence  of  the  destruction  of  some  large 
vessel  or  vessels  in  the  lungs  or  the  pleural  cavity  or  from  the  presence 
of  growths  we  find  extensive  hemorrhage  into  the  thoracic  cavity.  The 
physical  symptoms  are  similar  to  those  of  other  pleural  exudates,  but 
this  condition  comes  on  very  rapidly  and  in  this  condition  the  mucous 
membranes  become  very  pale.  When  the  symptoms  are  not  pronounced 
the  operation  of  puncture  will  determine  the  condition  positively.  Nor- 
mal hemorrhages  are  easily  and  quickly  absorbed,  but  often  where  there 
is  great  dyspnoea,  puncture  of  the  chest  wall  is  always  advisable. 

Other  Pathological  Conditions  of  the  Pleura. 

Besides  tubercular  deposits  we  find  endothelial  papillomas  which  are 
seen  in  the  form  of  velvety  or  grape-like  formations  on  both  sides  of  the 
mediastinal  coats  of  the  pleura  and  on  the  pleuritic  coat  of  the  diaph- 
ragm. These  formations  frequently  cause  a  low  form  of  chronic  pleuri- 
tis  (Kitt).  The  writer  has  observed  an  intrathoracic  chondroma  of 
great  size,  which  was  attached  to  the  ribs,  filling  up  the  left  thoracic 
side  and  pushing  the  left  lung  and  heart  to  the  right  side.  There  was 
severe    dyspnoea    and    anasarca. 


DISEASES  OF  THE  CIRCULATORY  APPARATUS. 

EXAMINATION  OF  THE  CIRCULATORY  APPARATUS. 

Examination  of  the  Heart. 

Anatomy  of  the  Heart. — The  normal  position  of  the  heart  may 
be  seen  in  Fig.  GG.  It  lies  on  the  left  side,  but  not  so  far  as  is  seen  in 
other  domestic  animals.  The  direction  of  its  axis  is  not  vertical,  l)ut 
extends  slightly  in  a  posterior  direction,  with  a  slight  curve  toward  the 
left  side.  The  base  of  the  heart  extends  from  the  third  to  the  seventh 
rib;  the  apex  extends  backward  toward  the  diaphragm.  Superiorly  the 
heart  lies  close  to  the  large  vessels — the  trachea  and  the  oesoi3hagus — 
and  close  on  all  sides  to  the  lobes  of  the  lungs.  In  its  inferior  portion  it 
lies  close  to  the  chest-wall,  extending  from  the  third  to  the  seventh  ril). 
In  the  heart-sections  we  find  the  following  arrangement:  the  right 
section  lies  in  a  right  anterior  direction  from  its  axis  and  the  left  lies 
in  a  left  posterior  direction. 


Fig.   66.— The  heart  in  position:  a.  Right  ventricle;  b,  left  ventricle;  c,  left  .auricle;  d,  right  auricle;/, 
pulmonary  artery;  g,  aorta;  k,  cesophagus;  /,  diaphragm. 


The  size  of  the  heart  varies  greatly  in  different  animals,  even  when 
in  a  normal  condition,  and  it  is,  therefore,  impossible  to  lay  down  any 
relative  rule  as  to  its  size  or  dimensions.  According  to  Colan,  the  weight 
of  the  heart  compared  with  that  of  the  body  is  1  to  90;  and  according  to 

154 


POSIT lOX  AXD  SIZE  OF   THE  HEART  155 

Rabe,  it  varies  from  1  to  40  to  100,  and  taking  relatively  all  the  breeds 
of  dogs,  and  also  of  sex  and  age,  the  relative  size  is  O.G  and  2.2  to  100. 

It  is  difficult  to  make  an  examination  of  the  heart  on  account  of  its 
position,  lying  as  it  does  hidden  between  the  lobes  of  the  lungs,  with  only 
a  small  portion  of  its  surface  exposed  where  it  can  be  heard,  and  from 
the  fact  that  it  varies  in  size  not  only  in  the  various  breeds,  but  also  in 
individuals.  We  find  that  in  animals  affected  with  the  various  heart 
affections  and  also  in  perfect  health  the  pulmonary  bruit  may  be  so  in- 
creased that  it  is  impossiljle  to  detect  when  there  are  weak  heart  sounds, 
as  the  largest  portion  of  the  heart  is  covered  by  portions  of  the  lungs, 
and  as  these  parts  also  make  sounds  the  ears  cannot  detect  the  sound. 
The  restlessness  of  the  animal  during  examination  and  the  movements 
of  the  cutaneous  muscles  and  the  coat  of  the  animal  are  all  factors  that 
assist  in  preventing  a  proper  examination  of  the  heart. 

The  following  details  must,  therefore,  be  looked  upon  to  a  certain 
extent  as  theoretical  in  character. 

In  making  an  examination  of  the  heart  we  must  consider  the  posi- 
tion and  size  of  that  organ,  its  palpitation  sounds,  and  character  of  the 
23ulsations. 

Position  and  Size  of  the  Heart. 

Both  are  to  be  detected  by  percussion,  but  for  the  reasons  above 
explained  it  rarely  answers  our  expectations.  In  percussion  over  the 
position  of  the  heart  we  find  in  normal  conditions  a  dull  sound  which 
lessens  in  deep  respiration.  The  position,  either  standing  or  recumbent, 
may  make  a  decided  difference. 

In  animals  having  a  small  heart,  the  sound  is  often  entirely  absent. 
The  sound  of  that  section  of  the  lung  that  lies  between  the  heart  and 
the  chest  wall  is  also  a  factor  that  makes  the  sound  dull,  and  it  is  only 
by  strong  percussion  that  anj'  sound  can  be  detected  at  all,  so  that  it 
may  hardly  be  said  to  be  of  much  diagnostic  value. 

There  may  be  an  abnormal  dulness  in  the  heart's  action  in  hyper- 
trophy, in  dilatation,  in  exudates  and  transudates  around  the  heart,  and 
in  retraction  or  contraction  of  the  lobules  of  the  lung  surrounding  the 
heart;  but  we  may  often  be  deceived  by  abnormal  processes  that  surround 
that  organ,  such  as  thickening  of  the  lung  sections  or  swards  on  the  pleura. 

The  dull  sound  is  absent  in  enlargement  of  the  lungs  by  emphysema, 
when  air  has  entered  the  pericardium,  after  injuries,  in  one-sided  pleuritis, 
and  in  pneumothorax.  The  sound  is  anteriorly  situated  in  the  chest 
when  there  is  intense  metcorization  of  the  stomach  or  intestines,  and  in 
ascites. 


156  DISEASES  OF  THE  CIRCULATORY  APPARATUS 


Character  of  the  Heart  Pulsations. 

The  pulsations  of  the  heart  can  be  distinguished  by  putting  the  hand 
on  the  inferior  portion  of  the  chest  near  the  sternum,  about  the  fifth  rib 
(on  the  right  side  the  pulsation  is  situated  a  little  more  anteriorly) .  The 
pulsation  makes  a  distinct  vibration  of  all  the  adjacent  parts,  and  in 
emaciated  animals  there  can  be  noticed  with  each  pulsation  a  distinct 
swelling  or  motion  of  the  lower  portions  of  the  ribs;  this  vibration  may 
be  greatly  lessened  by  the  presence  of  layers  of  fat  on  the  sides  of  the 
"chest.  After  great  exertion  or  excitement  the  strength  of  the  pulsation 
against  the  chest- w\all  is  greatly  increased. 

The  pulsations  of  the  heart  are  increased  by  disease  in  the  following 
conditions:  After  considerable  loss  of  blood,  in  any  case  of  fever,  in  pal- 
pitation of  the  heart,  in  some  forms  of  heart  disease,  in  hypertrophy  of 
the  heart,  or  by  the  influence  of  some  poisons,  such  as  digitalis  or  aconite. 
It  is  almost  imperceptible  in  degeneration  of  the  muscle  of  the  heart, 
in  the  later  stages  of  acute  diseases,  in  cases  of  poisoning,  in  fatty  de- 
generation of  the  heart,  and  when  the  heart  has  become  compressed  by 
the  effects  of  hydrothorax,  pneumopericarditis,  or  emphysema  of  the 
lungs.     It  is  distinguished  only  on  the  healthy  side  in  lateral  pleuritis. 

Character  of  the  Heart  Sounds  and  Bruits. 

In  order  to  distinguish  the  heart  sounds  we  must  put  the  ear  close 
to  the  side  directly  over  the  heart  where  the  beats  are  loudest;  it  is  better 
to  cover  the  place  with  a  handkerchief  or  cloth,  or  we  may  use  a  stetho- 
scope. We  should  hear  two  sounds  in  each  heart  beat — a  systolic, 
which  corresponds  to  the  ventricular  contraction,  and  a  diastolic,  which 
corresponds  with  the  beginning  of  the  diastole.  Both  these  sounds  follow 
each  other  with  short  intervals  between.  The  pause  between  the  first  and 
second  sound  is  short,  but  between  the  second  and  the  next  first  the  sound 
is  much  greater.  The  first  sound  is  a  mixed  muscular  and  valvular 
sound  of  the  mitrals  and  tricuspids,  and  the  second  is  a  semilunar  val- 
vular sound. 

Unfortunately  these  sounds  are  indistinct  and  mcomplete  in  the 
dog,  even  in  perfect  health.  In  very  fat  dogs  we  may  not  hear  any  heart 
sound,  or  we  may  only  hear  the  first  one.  In  well-fed  dogs  it  is  not  rare 
to  hear  the  first  sound,  which  is  a  great  deal  louder  than  the  second, 
only  on  the  left  side.  In  thin  animals  we  can  hear  the  sound  distinctly 
on  both  sides.  AVith  the  respiratory  bruit  we  lose  to  a  certain  extent  the 
full  strength  of  the  sounds,  and  often  only  the  first  sound  is  heard.  After 
great  activity  the  heart's  action  is  increased  so  much,  and  the  sounds 


CHARACTER  OF  THE  PULSE  157 

follow  each  other  so  rapidly,  that  it  is  impossible  to  distinguish  one  from 
another. 

In  pathological  conditions  the  heart  sounds  may  be  increased  l)y 
a  number  of  causes,  as  in  the  beginning  of  certain  fevers;  but  generally  it 
is  an  indication  of  hypertrophy.  A  lessened  heart  sound  is  found  in 
any  heart  weakness,  as  in  degeneration  of  the  heart  muscle,  in  accumula- 
tions of  exudates  around  the  heart  in  the  pericardium,  or  in  emphysema 
of  the  lung  sections,  etc.  In  such  cases,  as  a  rule,  the  heart  sound  is 
imperceptible. 

As  can  be  readily  seen,  it  is  by  no  means  easy  to  hear  the  heart  beat 
in  its  normal  condition,  and  the  condition  becomes  more  complicated 
when  we  have  to  distinguish  pathological  sounds — "heart  bruits."  We 
distinguish  between  endocardial  heart  bruits,  which  originate  in  the  heart 
direct,  and  pericardial  heart  bruits,  which  come  from  the  arterial  part  of 
the  heart  and  its  envelope.  The  former  are  divided  into  organic  and 
inorganic  bruits.  The  organic  heart  bruits  are  produced  by  stenosis 
(contraction)  of  the  ring  and  by  insufficient  or  imperfect  closing  of  the 
valves,  which  may  occvir  either  in  systole  or  diastole,  making  the  heart 
sound  indistinct,  or  it  may  be  entirely  absent,  and  the  bruit  takes  the 
place  of  the  heart  sound.  The  systolic  bruit  is  buzzing  or  blowing  in 
character,  and  indicates  an  imperfect  closing  of  an  arterio-ventricular 
valve  (in  most  cases  of  disease  of  the  mitrals).  The  diastolic  bruit  is 
rushing  or  wheezing  in  character,  and  indicates  a  stenosis  of  the  arterio- 
ventricular  ostia,  or  the  imperfect  closure  of  an  arterial  valve.  The 
inorganic  heart  bruit  is  seen  in  all  forms  of  anaemia,  and  occasionally  in 
fevers.  Pericardial  bruits  are  very  similar  to  pleuritic  fi'iction  sounds, 
that  is,  a  scratching  or  scraping  sound.  They  are  located  in  a  sharply 
defined  locality  and  do  not  occur  in  direct  rhythm  with  the  heart  sounds, 
but  seem  to  occur  between  them.  They  are  noticed  in  pericarditis  as 
soon  as  there  are  any  fibrinous  deposits  present  and  there  is  not  sufficient 
pericardial  fluid  present  to  keep  the  folds  free  from  contact  with  the 
heart.  A  change  in  the  position  of  the  animal  makes  quite  a  difference  in 
the  character  of  the  bruit,  and  it  may  easily  be  distinguished  from 
endocardial  sounds.  The  pericardial  friction  sound  is  distinguished 
from  the  pleural  friction  sounds  by  the  fact  that  it  is  entirely  inde- 
pendent of  the  movements  of  respiration. 

Character  of  the  Pulse. 

The  pulse  is  best  examined  in  the  femoral  artery,  inside  of  the  thigh, 
and  it  may  be  felt  also,  in  the  radial  artery,  inside  of  the  forearm.  In 
the  examination  of  the  pulse  we  must  take  into  consideration  its  fre- 
quency, its  cadence,  and  its  quality. 


158  DISEASES  OF  THE  CIRCULATORY  APPARATUS 

The  normal  pulse  varies  greatly,  according  to  the  breed,  age,  and 
size  of  the  animal,  and  is  rapidly  increased  from  such  causes  as  phys- 
ical efforts,  fear,  fright,  pleasure,  etc.  The  general  pulse  is  from  70  to 
120,  in  large  animals  being  less  and  in  very  small  animals  having  a  cor- 
respondingly freciucnt  pulse  rate.  The  rhythm,  (cadence)  should  be  reg- 
ular in  a  healthy  animal,  and  physical  causes  make  it  irregular;  but  an 
irregular  pulse  in  perfect  health  is  very  common  in  the  dog;  in  fact,  perfect 
rhythm  is  rare,  as  can  be  easily  demonstrated  by  taking  the  pulsations 
frequently,  the  irregularity  being  well  marked  in  very  young  or  old 
animals.     In  normal  conditions  the  pulse  must  be  similar  in  both  thighs. 

We  find  a  lessening  in  the  pulse  in  some  forms  of  poisoning,  fol- 
lowing hemorrhages,  in  affections  of  the  muscle  of  the  heart,  in  starvation, 
diseases  of  the  brain,  meningitis,  in  hepatogenous  icterus,  also  in  collapse 
and  in  diseases  characterized  by  a  continued  high  temperature. 

An  increase  of  the  pulse  is  found  in  all  fevers,  in  cases  of  valvular 
defects,  in  heart  w*eakness  and  paralysis  or  collapse  of  that  organ  from 
continued  high  fever.  When  the  temperature  increases  the  pulse  rises. 
The  pulse  is  irregular  (arhythmic)  in  some  diseases  of  the  heart  (in- 
compensated  valvular  defects,  myocarditis)  after  large  doses  of  digitalis, 
and  in  heart  weakness.  It  is  only  intermittent  (as  a  forerunner  of 
entire  irregularity)  in  slight  cases  of  valvular  defects,  in  some  diseases 
of  the  brain,  and  in  gastricism.  The  pulse  is  full  and  bounding  under 
great  physical  exertion,  small  and  collapsed  after  severe  hemorrhage 
and  in  enteritis.  In  intense  heart  weakness  and  collapse  it  becomes 
thread-like  and  imperceptible. 

The  venous  pulse — that  is,  the  apparent  increase  in  the  amount 
of  l)lood  in  the  jugular  at  its  entrance  into  the  chest — is  often  seen  in 
the  dog.  It  is  generally  a  symptom  of  some  chronic  heart  affection,  such 
as  imperfect  closing  of  the  tricuspid  valves,  and  of  heart  weakness. 

DISEASES  OF  THE  HEART. 

Acute  Endocarditis.     Endocarditis  Verucosa ;  Endocarditis  Ulcerosa. 

Etiology. — This  disease  is  comparatively  rare.  Jensen  ropoi'ts 
that  ovit  of  a  clinic  of  3,240  dogs,  he  found  13  with  ulcerative  endocardi- 
tis. This  condition  may  be  caused  by  a  sympathetic  irritation  of  myo- 
carditis or  mediastinitis,  but  this  is  extremely  rare,  it  being  caused  by 
the  presence  in  the  blood  of  certain  microorganisms  which  lodge  on  the 
endocardium,  particularly  in  the  vah^es  and  the  deeper  portions  between 
the  trabecule,  causing  inflammation  of  the  tissues.  Endocarditis  can 
l)e  produced  experimentally  by  the  introduction  into  the  blood  of  vari- 
ous forms  of  bacteria  (staphylococcus,  streptococcus,  etc.)    particularly 


ENDOCARDITIS  159 

if  the  valves  have  been  previously  affected  with  inflammatory  processes. 
Consequently  it  is  very  apt  to  appear  in  such  diseases  as  distemper, 
septicaemia,  pyemia,  articular  rheumatism,  and  in  rare  instances  in  tuber- 
culosis; it  may  also  follow  wound  abscesses,  chronic  ulcerated  inflam- 
mations of  the  skin  (dermatitis),  and  as  a  consequence  of  some  unknown 
bacterial  invasion.  Frohner  and  Jensen  have  observed  an  infectious 
malignant   endocarditis. 

Pathological  Anatomy. — "While  we  differentiate  between  endocar- 
ditis verucosa  and  endocarditis  ulcerosa  (endocarditis  diphtherica,  endo- 
carditis maligna),  one  may  follow  the  other.  The  former  (the  milder 
form)  commences  with  the  formation  of  various  sized  wart-like  protuber- 
ances on  the  free  edges  of  the  valves  and  their  attachments,  and  also  on 
the  trabeculte  and  papillary  muscles;  when  the  latter  are  attacked,  it 
may  cause  necrosis  and  tumefaction  of  the  endocardium.  This  condition 
may  cause  the  formation  of  eml)oli  which  get  into  the  circulation,  are 
liberated,  and  produce  grave  conditions  in  various  organs  of  the  body. 
The  aortic  and  the  bicuspid  valves  are  more  frequently  affected;  the 
pulmonary  and  tricuspid  valves,  very  rarely. 

Clinical  Symptoms  and  Course. — There  may  be  little  or  no  fever  in 
the  onset  of  the  disease,  but  if  there  is  fever  present  it  is  generally  high. 
The  general  condition  is  greatly  disturbed,  increased  irregular  heart 
action,  pulse  Aveak  and  irregular;  on  ausculation  the  pulsation  is  heard 
and  little  change  is  noticed  in  the  early  stages  before  any  material 
alteration  has  been  made  in  the  valves.  Later,  when  the  deposits  become 
organized,  the  heart  beat  is  muffled  and  the  two  sounds  of  the  heart 
become  one,  or  an  early  systole  and  diastolic  murmurs.  The  respirations 
are  more  or  less  accelerated  and  labored,  there  is  cyanosis  of  the  visible 
mucous  membranes  and  with  these  symptoms  there  may  be  certain  met- 
astatic changes  in  other  organs. 

The  course  of  the  disease  varies;  in  some  cases  death  occurs  in  a 
very  short  time,  in  the  majority  of  cases,  hoAvever,  the  disease  progresses 
slowly,  the  symptoms  may  increase  in  severity;  they  may  decrease  in 
severity  and  the  animal  be  comparatively  well  for  w'eeks,  and  then  the 
acute  symptoms  may  recur  and  the  disease  become  chronic.  In  mild 
cases  animals  may  take  complete  recoveries,  but  this  is  comparatively 
rare. 

Therapeutics. — Rest,  avoid  any  excitement,  cold  compresses,  such 
as  an  ice-bag  over  the  region  of  the  heart;  where  there  is  a  small  irregular 
pulse  we  should  administer  digitalis,  strophanthus,  or  caffeine.  ^^  hen 
dangerous  symptoms  appear,  subcutaneous  injections  of  camphor,  ether, 
or  atropin.  For  the  fever  we  should  use  salicylate  of  soda,  aspirin, 
cinchona,  antipyrin  or  antifebrin. 


160  DISEASES  OF  THE  CIRCULATORY  APPARATUS 

Valvular  Diseases  of  the  Heart;  Chronic  Endocarditis;  Valvular  Defects. 

General  Notes  on  Valvular  Defects. — By  valvular  defects  we  under- 
stand such  anatomical  alterations  in  the  valves  and  openings  as  lead 
to  an  irregularity  in  the  circulation  of  the  blood,  becoming  apparent  by 
visible  symptoms  in  the  pulse  or  general  condition;  but  those  slight  val- 
vular defects  so  often  seen  in  post-mortems  and  never  noticed  during 
life  are  not  to  be  considered. 

Valvular  defects  appear  in  two  forms:  first,  when  the  valves  close 
impei'fectly;  second,  when  the  openings  become  contracted,  causing 
stenosis.  Imperfect  closure  of  one  valve  causes  a  certain  amount  of 
blood  to  flow  back  into  the  portion  of  the  heart  from  which  it  has  just 
come;  for  instance,  when  there  is  imperfect  action  of  the  mitrals  or  of 
the  tricuspids  in  systole,  part  of  the  contents  of  the  ventricles  rushes  back 


Fig.   67. — Diagram  of  the  blood  circulation. 

into  the  auricles,  and  when  there  is  insufficient  action  of  the  semilunar 
valve  in  the  diastole,  a  part  of  the  blood  that  has  been  thrown  into  the 
artery  returns  into  the  chamber  again. 

Stenosis  of  one  opening  retards  the  passage  of  blood,  when  we  have 
a  contraction  of  an  arterio-ventricular  opening.  At  the  time  of  diastole 
the  blood  is  kept  back  at  the  entrance  of  the  affected  ventricle,  and  it 
is  imperfectly  filled,  while  in  the  aortic  opening  in  pulmonic  stenosis  the 
exit  of  the  blood  out  of  the  ventricles  (Fig.  67)  in  the  systole  is  retarded. 
In  any  of  these  conditions  there  is  imperfect  heart  action;  every  defect  of 
an  arterial  opening  interferes  with  perfect  ventricular  action  and  every 
defect  in  a  venous  opening  causes  a  corresponding  lessening  of  power  in 
the  auricle. 

An  abnormal  pumping  of  the  blood  in  this  manner  is  sure  to  cause 
more  or  less  disturbance  of  the  entire  organism,  but  there  are  certain 
compensatory  processes  in  the  heart  itself  that  tend  to  overcome  this. 
As  a  consequence  of  the  impaired  flow,  the  heart  muscle  is  worked  much 
harder  and  becomes  hypertrophied  (compensating  heart  hypertrophy). 


VALVULAR  DEFECTS  161 

We  often  see  cases  where  defects  of  the  fiorta  become  equalized  by  a  hy- 
pertrophy of  the  left  ventricle.  In  valvular  defects  of  the  mitrals  the 
stagnation  of  the  blood  occurs  in  the  veins,  capillaries,  and  arteries  of  the 
lungs,  and  as  far  back  as  the  right  ventricle,  which  becomes  dilated  and 
hypertrophied  while  trying  to  take  up  the  extra  work  thrown  on  it. 
In  course  of  time  we  also  see  hypertrophy  and  dilatation  of  the  left 
ventricle;  during  diastole  the  stagnated  blood  runs  in  great  quantities 
into  it  out  of  the  dilated  auricle. 

These  compensating  processes  of  the  heart  are  apt  to  prevent  for  a 
long  time  any  great  functional  disturbance  provided  the  heart  receives 
its  proportional  nutrition.  If  this  is  not  the  case,  for  instance,  in  anaemic 
and  cachectic  feverish  animals,  the  compensating  heart  hypertrophy  is  not 
present  or  is  only  developed  to  a  slight  degree,  and  also  in  cases  of  insufh- 
cient  nutrition,  due  to  some  alteration  in  the  coronary  artery,  the  heart 
is  no  longer  able  to  satisfy  the  demands  claimed  from  it  and  tires  out, 
and  all  the  effects  of  lilood-stagnation  rapidly  show  themselves. 

Etiology  of  Deficient  Valvular  Action  of  the  Heart. — The  most  com- 
mon causes  of  valvular  defects  are  endocarditic  processes,  which  are  de- 
veloped on  the  valves  and  take  an  acute  course,  according  to  the  amount 
of  the  irritation,  and  cause  a  fibrinous,  rigid  thickening  of  the  valves. 
Sooner  or  later  we  find  an  imperfect  closure  of  the  valvular  openings 
through  cicatricial  contractions  and  adhesions  to  the  lobula  of  the  valves 
or  in  their  neighl)orhood.  This  condition  is  quite  common  in  old 
dogs,  and  may  appear  as  a  result  of  great  nervous  excitement,  cold, 
articular  rheumatism,  distemper,  and  other  infectious  diseases.  Car- 
diac valvular  changes  are  frequently  seen  as  a  result  of  chronic  nephri- 
tis. The  mitral  valves  are  most  frequently  affected.  Cadiot  and  Ries 
found  out  of  thirteen  cases,  five  of  the  mitral,  four  of  mitral  and  tricus- 
pid, two  of  the  tricuspid  alone,  and  one  of  the  valve  of  the  aorta  and  one 
mitral  and  aorta.  AVe  may  also  see  deposits  of  lime  salts  and  a  con- 
traction of  the  opening  belonging  to  the  alTected  valve.  In  rare  cases 
there  is  heart  weakness  and  imperfect  valvular  action,  which  may  be 
caused  by  a  dilatation  of  the  opening,  and,  thus  becoming  abnormally 
distended,  the  valves  cannot  meet  and  make  a  complete  closure.  Ath- 
eromatous processes  may  also  produce  this  condition.   . 

General  Symptoms  of  Deficient  Valvular  Action  of  the  Heart. — The 
symptoms  which  a})pear  at  a  certain  time  in  all  valvular  troubles  are 
as  follows:  Increase  of  heart  and  pulse  action  (after  slight  exertion  it  is 
al)normally  increased);  palpitation  of  the  heart;  difficulty  in  respiration; 
vertigo  after  any  exertion;  cyanosis  of  the  visible  mucous  meml)ranes, 
especially  of  the  head;  venous  pulse;  dropsical  effusions,  such  as  oedema  of 
the  legs,  abdomen,  or  testicles;  hydrothorax;  hydropericartlium;  ascites; 
allDuniinuria,  with  lessening  of  the  amount  of  urine;  complications  of  the 
11 


162  DISEASES  OF  THE  CIRCULATORY  APPARATUS 

digestive  organs  of  various  kinds,  and,  finally,  general  nutritive  dis- 
turbances, such  as  ananiia,  emaciation,  etc. 

Symptoms  of  Valvular  Deficiency  in  one  Opening.  Insufficiency 
of  the  Mitrals. — The  imperfect  closing  of  two  of  the  valves  occurs  very 
frequently  in  the  dog.  Besides  the  alterations  of  the  valves  we  find 
hypertrophy  and  dilatation  of  the  left  auricle  of  the  heart,  and  in  the 
later  stages  also  of  the  right  ventricle. 

The  clinical  symptoms  are:  Increase  of  the  pulse  and  distention  of 
the  artery,  systolic  bruit  heard  on  the  left  wall  of  the  chest,  increase  of  the 
second  (pulmonic)  sound,  weak,  frequent  pulse,  shortness  of  breath,  and 
later  dropsy,  etc. 

Stenosis  of  the  Left  Venous  Opening. — This  is  generally  accom- 
panied by  mitral  insufficiency.  It  leads  also  to  dilatation  and  hyper- 
trophy of  the  left  auricle  and  the  right  ventricle,  and  in  such  cases  the 
left  ventricle  is  generally  small,  narrow,  and  contains  little  blood. 

The  clinical  symptoms  are:  Slight  increase  in  the  pulse,  diastolic 
bruit  (this  is  absent  in  some  cases) ;  considerable  increase  of  the  second 
(pulmonic)  bruit,  very  small,  irregular  pulse;  great  difficulty  in  respira- 
tion, and  dropsy  makes  its  appearance  early  in  the  disease. 

Disease  of  the  Aortic  Valves. — This  condition  of  the  semilunar  valves, 
causes  a  dilatation  and  hypertrophy  of  the  left  ventricle  and  flattening 
of  the  papillary  muscles. 

The  clinical  symptoms  are  as  follows:  A  very  strong  heartbeat; 
increase  of  the  heart  dulness  on  the  left  side,  and  a  full,  bounding  pulse, 
is  very  frequently  noticed.  This  character  of  the  pulse  is  also  noticed  in 
small  arteries  that  in  normal  conditions  have  no  distinct  pulse.  We  also 
find  shortness  of  l)reath,  oedema,  and  dropsy  of  the  dependent  parts. 

Stenosis  of  the  Aortic  Opening. — Rare  in  the  dog.  The  clinical 
symptoms  are  a  systolic  bruit,  a  very  slight  sound  of  the  aorta,  small, 
weak  pulse,  general  amemia,  etc. 

Imperfect  action  and  disease  of  the  tricuspid  valves  cause  distention 
of  the  right  auricle  and  also  a  systolic  murmur  on  the  right  side  and  a 
strong,  venous  pulse.  Stenosis  of  the  right  venous  opening  and  defects 
of  the  pulmonary  valves  are  extremely  rare. 

We  very  frequently  have  a  combination  of  a  contraction  of  an 
opening  and  also  a  deposit  on,  or  retraction  of,  the  valve  at  that  opening, 
and  also  a  single  valvular  defect;  these  two  make  a  combination  of  symp- 
toms that  are  rather  hard  to  separate. 

Prognosis  and  Therapeutics  of  Valvular  Defects  of  the  Heart. — A 
diseased  valve  must  ha  considered  incurable,  but  it  may  exist  for  a  long 
time  without  causing  any  decided  disturbance  of  the  general  circulation. 
It  is  impossible  to  predict  how  long  a  "  compensating"  state  will  continue. 
Mitral  defects  seem  to  last  the  longest.     This  conculsion  is  arrived  at 


DISEASES  OF   THE  HEART   MUSCLE  1G3 

from  the  fact  that  it  is  quite  common  to  find  serious  heart  defects 
in  post-mortems  on  dogs  that  have  been  apparently  heahliy  during 
life. 

Compensating  heart  defects  do  not  require  any  treatment.  We 
try  to  aid  the  heart  in  its  efforts  by  giving  nutritive  diet  and  removing  all 
exciting  causes,  such  as  great  or  prolonged  exertion. 

As  soon  as  the  heart  begins  to  weaken  and  the  difficulty  in  respiration 
increases,  accompanied  by  oedema,  palpitation,  etc.,  we  must  use  heart 
tonics,  such  as  digitalis,  strophanthus,  caffeine,  etc. 

■7.     Tine,  strophanthus,  15.0 

Sig. — Ten  to  twenty  drops  morning  and  evening. 
J\.     Caffeine  nitricum,  0.5 

M.  F.  charta  Xo.  x. 

Sig. — One  powder  morning  and  evening. 
I^.     Caffeine  citrate,  .3.0 

Tinct.  digitalis,  4.0 

AquiB,  64 . 0 

Sig. — One  teaspoonful  twice  daily. 

If  by  medicinal  treatment  we  succeed  in  reestablishing  a  compensat- 
ing action,  the  anlema  gradually  disappears;  if,  how^ever,  we  do  not  get 
the  desired  result  and  there  should  be  any  oedema  remaining,  Ave  must 
treat  it  symptomatically,  using  those  diuretics  mentioned  under  the 
treatment  of  pleurisy,  particularly  theol:)romin  (rather  than  calomel). 
AVhere  there  is  decided  palpitation,  we  must  use  cold  compresses  in  the 
region  of  the  heart,  or  subcutaneous  injections  of  morphia.  In  milder 
cases  use  the  salts  of  In-omine.  Great  weakness  of  the  pulse  must  be 
treated  with  alcohol,  ether,  or  camphor,  etc.  Tine,  nux  vomica  may  be 
given  in  doses  of  one  drop  three  times  daily  when  the  appetite  is  poor. 

The  symptoms  alcove  described  are  sometimes  found  in  dogs  that 
do  not  present  any  marked  alterations  in  the  valves  or  openings,  either 
during  life  or  on  post-mortem;  these  are  due  either  to  simple  idiopathic 
hypertrophy  and  dilatation  or  to  alteration  of  the  heart  muscle. 

Diseases  of  the  Heart  Muscle. 

Idiopathic  Hypertrophy  and  Dilatation  of  the  Heart. — We  find  on 
post-mortem,  as  a  rule,  a  hypertrophy  of  the  left  ventricle,  but  oc- 
casionally it  is  of  both  ventricles.  At  the  same  time  we  do  not  find 
any  alteration  of  the  lungs  or  kidneys  which  might  produce  secondary 
hypertrophy  of  the  heart  muscle.  The  causes  are  extreme  and  constant 
exertion,  cold,  abnormal  excitability  of  the  heart  (in  closely  bred  lap 
dogs),  overfeeding,  and  too  much  rich  blood  (as  in  pet  animals). 


164  DISEASES  OF  THE  CIRCULATORY  APPARATUS 

Chronic  Myocarditis,  Indurative  Degeneration  of  the  Heart,  Inflam- 
matory Myocarditis. — This  condition  may  follow  an  attack  of  acute 
distemper  and  is  often  mistaken  for  valvular  defects.  In  this  con- 
dition the  heart  is  greatly  enlarged  and  dilated,  and  the  walls  are 
hypertrophied.  The  body  of  the  heart  muscle  is  filled  with  a  number 
of  whitish  hard  bodies  which  on  examination  are  found  to  be  cicatricial 
connective  tissue. 

The  cause  of  the  existence  of  these  bodies  has  not  been  fully  deter- 
mined, but  they  are  due  either  to  myocarditis  or  to  defective  nutrition 
of  the  heart  muscle,  as  a  consequence  of  contraction  or  atrophy  of  the 
coronary  artery. 

The  clinical  symptoms  presented  are  as  follows:  Weak  heart, 
palpitation,  dizziness,  vertigo,  increase  in  the  numljer  of  pulse,  and  drop- 
sical effusions. 

Auscultation  gives  nothing  but  pure  heart  sounds,  and  with  the  above 
symptoms  there  may  be  a  callous  degeneration  of  the  heart  or  a  pure  idio- 
pathic hypertrophy,  as  during  life  it  is  impossil^le  to  determine  which,  and 
treatment  in  both  cases  is  the  same.  Treatment  is  of  no  practical  value; 
it  consists  of  protection  against  excitement  or  great  bodily  exertion; 
give  nutritive,  easily  digested  food,  and,  if  the  heart  is  irregular,  heart 
tonics. 

Other  Diseases  of  the  Heart. 

Nervous  Palpitation,  Palpitation  of  the  Heart. — In  this  condition  the 
physical  examination  reveals  no  anatomical  alteration  of  the  heart.  The 
heart  beats  with  great  force,  so  that  it  can  be  noticed  distinctly 
on  the  external  thoracic  walls;  the  beat  is  clear  and  in  cases  where  the 
palpitation  is  great,  the  heart  makes  only  one  sound;  the  respirations 
are  accelerated  and  shallow,  the  animal  is  anxious  and  restless,  but,  as  a 
rule,  if  kept  quiet,  the  attack  soon  passes  off.  If  continued  apply  cold 
compresses  in  the  region  of  the  heart  and  give  a  hypodermic  solution  of 
morphine  or  administer  sodium  bromide,  chloral  hydrate,  etc. 

Tumors  of  the  Heart. — These  mentioned  by  a  number  of  avithors  are 
cither  of  sarcomatous  or  fibrous  nature,  are  usually  never  diagnosed 
during  life,  but  may  be  seen  on  the  post-mortem  of  an  animal  dying 
suddenly. 

Parasite^  in  the  Heart  Muscles. — Cysticercus  or  bladder  worms  are 
foiuid  1x1  ine  heart.  Lindmere  found  in  the  external  strata  of  the  tissue 
in  the  heart  of  a  dog  a  number  of  cysts  al:)out  the  size  of  a  hazelnut 
which  were  filled  with  a  clear  fluid,  which  seemed  to  be  the  cysticercus 
cellulosse.  There  was  nothing  to  indicate  that  these  parasites  caused  the 
heart  the  sliohtest  irritation. 


PERICARDITIS  165 

DISEASES  OF  THE  PERICARDIUM. 
Pericarditis. 

{Inflammation  of  the  Heart  Envelope.) 

Etiology. — Inflammation  of  the  pericardium  may  originate  in  a 
primary  way  by  traumatisms  or  cold,  or,  secondarily,  in  connection 
with  infectious  or  inflammatory  diseases  of  the  neighboring  organs,  es- 
pecially pleuritis,  or  disease  of  the  endocardium  and  myocardium.  It  is 
a  question  whether  this  condition  can  originate  from  perforation  of  lung 
abscesses  or  from  foreign  bodies  coming  from  the  oesophagus.  Tul^er- 
culosis  seems  to  be  the  most  frequent  exciting  cause  of  this  disorder. 
Traumatisms  such  as  gunshot  wounds,  fracture  of  ribs,  may  cause  peri- 
carditis. Cold  or  rheumatism  is  said  to  be  a  predisposing  cause  of  peri- 
carditis, but  this  theory  is  very  doubtful. 

Pathological  Anatomy. — Pericarditis  occurs  either  in  the  acute  or 
chronic  form.  The  anatomical  alterations  that  it  produces  on  both  sur- 
faces of  the  pericardium  correspond  to  those  on  the  pleura  caused  by 
pleuritis  and  occur  in  the  following  forms,  fibrous,  hemorrhagic,  puru- 
lent or  icteric.  The  most  common  form  is  serofibrinous  pericarditis, 
with  copious  liquid  exudates  in  the  pericardium  and  masses  of  fibrinous 
Ij-mph  attached  to  the  surface  of  the  pericardium;  in  very  rare  instances, 
the  folds  are  attached  to  each  other.  When  this  condition  has  been 
present  some  time,  the  pericardium  becomes  dilated  and  relaxed  and 
the  heart-muscle  shows  more  or  less  atrophy. 

Clinical  Symptoms. — Slight  pericarditis  rarely  shows  itself  to  any 
marked  degree,  but  in  severe  cases  there  is  decided  palpitation,  the  pulse 
becoming  weak  and  indistinct,  with  marked  irregularity  in  the  rhythm. 
On  auscultation  there  is  great  dulness  all  over  the  region  of  the  heart; 
finally  the  heart  sound  is  entirely  lost  or  simply  a  pericardial  rubbing 
bruit  is  heard.  "When  the  pericardial  folds  are  attached  or  when  they 
are  separated  by  effusions  this  sound  disappears. 

There  may  be  an  increase  of  temperature,  loss  of  appetite,  and  the 
slightest  exertions  cause  marked  increase  in  the  respiration  wuth  cyanosis 
of  the  visible  mucous  membranes.  As  soon  as  the  disease  .becomes  ad- 
vanced, the  same  symptoms  that  are  seen  in  any  case  of  defective  heart 
action  are  noticed;  the  lessened  arterial  pressure  causes  irregularity  in 
the  action  of  the  urinary  apparatus,  and  from  venous  stagnation  dropsy 
shows  itself  in  different  parts  of  the  body,  especially  in  the  extremities. 
As  a  result  of  acute  infectious  diseases,  pleuritis  and  pleuro-pneumonia, 
we  may  have  acute  inflammation  of  the  pericardium  and  death  as  a 


166  DISEASES  OF  THE  CIRCULATORY  APPARATUS 

result.  Chronic  pericarditis  may  also  produce  death;  its  action^  how- 
ever, is  slower. 

Therapeutics. — Keep  the  animal  as  quiet  as  possible;  give  nutritive, 
easily  digested  food  (meat  diet  or  milk)  and  such  agents  as  will  lessen  the 
fever  and  tone  up  the  heart.  The  Priessnitz  compress  and  cold-water 
compresses  might  produce  better  effects,  but  they  excite  the  animal  and 
thus  do  more  harm  than  good.  Laxatives,  such  as  sulphate  of  magne- 
sium or  sodium,  Epsom  salts,  calomel.  As  heart  tonics  give  strophan- 
thus  or  digitalis,  etc.  When  the  exudate  accumulates  to  an  alarming 
extent,  we  must  resort  to  surgical  means  and  empty  the  pericardium  by 
means  of  the  trocar,  as  in  pleuritic  effusions,  and  must  be  careful  to 
use  as  long  and  as  thin  a  trocar  as  possible.  (An  aspirating  syringe 
needle  is  the  best.)  Select  a  space  over  the  dullest  part  of  the  heart 
and  insert  the  trocar  low  down  in  the  left  .chest  wall,  taking  care  not  to 
put  the  point  in  too  deep  and  thus  injure  the  heart  itself. 

The  treatment  of  pericarditis  is  generally  symptomatic.  If  great 
weakness  of  the  pulse  is  observed  administer  wine,  alcohol,  ether,  or 
camphor;  the  latter  seems  to  be  best  to  use  for  this  particular  affection. 

Dropsy  of  the  pericardium  (hydropericardium)  is  a  collection  of 
fluid  in  the  pericardium  without  any  direct  inflammation  of  the  serous 
pericardium. 

In  health  the  pericardium  always  contains  a  small  amount  of  fluid, 
and  it  is  only  when  we  recognize,  by  physical  means,  a  very  much  in- 
creased amount  of  fluid  in  the  sac  that  it  can  be  called  hydropericarditis. 
Dropsy  of  the  pericardium  may  appear  as  a  symptom  of  various  diseases 
(defects  of  the  valves,  inflammation  of  the  heart  muscle,  diseased  con- 
ditions of  the  coronary  arteries  or  of  the  kidneys,  and  acute  anaemia) 
as  well  as  in  connection  with  inflammation  of  the  pericardium  and  is 
generally  accompanied  with  all  the  symptoms  of  general  dropsy. 

The  clinical  symptoms  are  those  of  pericarditis;  the  friction  bruit 
and  the  increase  of  temperature  are  absent;  however,  the  treatment 
consists  in  removing  the  original  causes  and,  if  this  cannot  be  done,  to 
puncture.  Diuretics  (digitalis)  are  to  be  administered,  but  these,  as  a 
rule,  only  produce  temporary  effect. 

Hemorrhage  of  the  Pericardium  (Haemopericardium). — This  is  rarely 
seen.  It  may  be  caused  by  gunshot  wounds,  by  a  bursting  aneurysm,  or 
by  laceration  of  one  of  the  coronary  arteries  (see  also  spiroptera  san- 
guinolenta),  rupture  of  heart,  or  the  formation  of  tumors,  etc.,  of  the  myo- 
cardium. Death  by  compression  of  the  heart  generally  occurs  in  a 
short  time.  Where  results  are  not  fatal  in  a  short  time — that  is,  where 
the  blood  oozes  out  slowly  and  fills  the  sac  gradually — it  is  impossible 
to  make  a  certain  diagnosis  unless  the  diagnosis  is  based  on  the  appear- 
ance of  acute  anaemia.     This  is  also  the  case  when  air  (pneumopericarditis) 


FI LABIA  IN  THE  BLOOD  1G7 

or  blood  penetrates  into  the    cavity  from  the  lungs  in  eases  of  some 
traumatism  of  those  organs. 

FILARIA  IN  THE  BLOOD. 

Four  kinds  of  parasites  have  l^een  found  in  the  lilood  of  the  dog, 
namely  Filaria  immltis,  Hsematozoon  lewisi,  Strongylus  vasorum,  and 
Spiroptera  sanguinolenta. 

Filaria  Immitis,  Filaria  Haematica. — (Males  10  cm.  and  females  35 
cm.  long;  both  1.5  mm.  thick.)  They  lie  inside  of  the  heart;  very  rarely 
in  the  left,  generally  on  the  right,  where  they  multiply  in  great  num- 
bers, often  hundreds  massed  in  a  ball  (Megnin) ;  they  are  rarely  found 
in  any  other  part  of  the  vascular  system;  on  the  other  hand,  the  eml^ryos 


Fig.  68. — Heart,  with  Filaria  immitis  in  the  ventricle  (photograph) . 

measure  0.25  mm.  long  and  5  mm.  thick,  are  found  in  the  circulation  in 
hundreds  of  thousands  and  can  be  readily  seen  under  the  microscope  in  a 
sample  of  blood  of  the  affected  animal  (Delafond,  Xocard,  Gruby,  Renther, 
Johne,  Rieck,  Deffe,  and  others).  The  mature  filarise  living  in  the 
heart  (Fig.  68),  cause  disturbances  of  the  circulatory  system,  dilatation 
and  hypertrophy  of  the  heart,  endocarditis,  formation  of  thrombi  with 
all  its  results,  and  even  rupture  of  the  heart.  The  embryo  may  plug  up 
the  small  arteries  particularly  of  the  lungs,  brain,  and  spleen.  The  em- 
bryos seem  to  be  excreted  through  the  kidneys.  This  parasite  is  gener- 
ally found  in  Indian,  Chinese,  and  American  dogs,  especially  in  the  south- 
ern states.  Wheeler  rarely  made  a  post-mortem  that  he  did  not  find 
it,  often  without  presenting  any  observable  symptoms  during  life.  It  is 
rarely  found  in  Europe.  The  clinical  symptoms  are  not  at  all  character- 
istic— emaciation,  epileptiform  convulsions,  disturbance  of  the  heart  ac- 
tion, intestinal  hemorrhage,  and  excitement — but  frequently  the  filaria  may 


1C8  DISEASES  OF  THE  CIRCULATORY  APPARATUS 

exist  in  great  numbers  and  none  of  these  symptoms  be  present — uncon- 
sciousness, cl3^spnoea,  and  rabiform  symptoms.  How  the  parasites  find 
their  way  into  the  blood  is  rather  interesting.  The  embryo  is  passed  in  the 
urine  and  carried  by  air  or  water  into  rice  fiekls  or  swampy  places,  and 
the  parasite  finds  its  way  into  the  system  through  the  dog  drinking  the 
water.  Some  authors  contend  that  the  larvae  get  into  the  blood  as  the 
larvse  of  the  Filaria  sanguinis  of  man  by  being  first  absorbed  by  the  mos- 
quito and  then  developed  and  passed  again  to  the  dog. 

Frohner  tried  to  reinoculate  a  dog  intravenously  with  blood  con- 
taining the  embryo,  but  with  negative  results. 

As  to  prophylactic  or  therapeutic  measures,  nothing  has  as  yet  been 
found  to  answer  the  purpose.  In  regions  where  the  parasites  exist,  the 
administration  of  boiled  or  filtered  water  could  be  carried  out  only  in  the 
case  of  household  pets;  diuretics  tend  to  wash  the  parasites  from  the 
kidneys.  Frohner  says  that  in  Japan,  where  the  parasite  is  prevalent,  ar- 
senic is  used  with  advantage. 

Hsematozoon  Lewisi. — These  parasites  are  very  small,  resembling 
Filaria  immitis  found  in  India,  China,  Italy,  and  France.  Grassi  thinks 
the  larvse  develop  in  the  fleas  and  lice  that  infest  the  dog. 

Strongylus  Vasorum  (Haematozoon  Subulatum). — These  exist  in 
France  and  in  certain  parts  of  Italy.  Leisering  found  them  in  the  blood, 
lungs,  prostate,  and  the  spongy  portion  of  the  penis.  He  considers 
Ha?matozoon  subulatum  to  be  identical  with  Strongylus  vasorum  or 
one  simply  to  have  taken  a  different  form.  These  parasites  produce 
anaemia,  gradual  emaciation,  irregularity  of  the  heart's  action,  and 
cough. 

Spiroptera  Sanguinolenta  (Filaria  Sanguinolenta) . — This  parasite 
has  already  been  described  on  page  51.  In  its  larval  form  it  is  found 
forming  aneurysms  which  burst  and  form  hemorrhages  into  the  pericard- 
ium, or  entering  the  pulmonary  circulation  incomplete  are  carried  into 
the  lungs. 


DISEASES  OF  THE  URINARY  AND  SEXUAL  APPARATUS. 

EXAMINATION  OF  THE  URINARY  APPARATUS. 

This  comprises  the  examination  of  the  prepuce,  urethra,  prostate, 
bhickler,  kidneys,  the  vulva  in  the  female,  and  especially  of  the  urine. 


Examination  of  the  Prepuce,  Vulva  and  Urethra. 

If  a  glossy  or  purulent  discharge  comes  from  the  prepuce,  it  indicates 
a  catarrhal  condition  of  the  part  (catarrh  of  the  foreskin  or  gonorrhoea 
of  the  prepuce).  If  the  discharge  is  purulent,  bloody,  and  has  a  foetid 
odor,  we  will  find  wounds,  ulceration,  swellings,  or  new  formations,  on 
the  prepuce  or  the  glans.  To  make  an  examination  of  the 
penis,  we  must  lay  the  animal  on  its  side,  take  hold  of  the 
base  with  one  hand  and  with  the  other  retract  the  foreskin, 
so  as  to  expose  the  penis  as  far  back  as  the  glans,  and  in 
this  way  it  is  comparatively  easy  to  make  an  examination. 
If  it  is  found  impossible  to  expose  the  free  portion  of  the 
penis,  it  indicates  phimosis  or  an  abnormally  narrow  open- 
ing of  the  prepuce,  while  paraphimosis  is  a  condition  in 
which  the  greatly  distended  glans  is  outside  of  the  open- 
ing of  the  retracted  prepuce.  Catarrhal  affections,  (ure- 
thral or  gonorrhceal)  of  the  urethra  are  very  rare  in  the 
dog.  They  are  recognized  by  a  discharge  of  purulent  mucus 
from  the  urethra,  by  difficulty  in  urination,  and  the  animal, 
on  catheterization,  may  pass  purulent  mucus  from  the 
urethra.  In  cases  where  there  is  great  difficulty  in  passing 
urine,  or  where  it  is  retained  entirely,  it  becomes  necessary 
to  pass  the  catheter  or  sound.  When  this  retention  of  urine 
occurs,  it  is  generally  due  to  the  presence  of  a  stone  in  the 
bladder,  a  collection  of  stones  in  the  urethra,  or  swelling  of 
the  prostate,  but  it  may  also  indicate  cicatricial  strictures 
of  the  urethra,  irritants,  acute  cystitis,  distention  of  the 
bladder  by  prolonged  retention  of  urine,  stone  of  the  bladder,  or  neo- 
formations  in  the  bladder. 

Passing  the  catheter  in  the  dog:     It  is  best  to  use  an  ordinary  rubber 
catheter  in  the  male  dog  (about  2  to  5  mm.  in  diameter  and  the  ordinary 

109 


Fig.  69.— 
Male  catheter. 


170      DISEASES  OF  THE  URINARV  AND  SEXUAL  APPARATUS 

length),  Fig.  69.  The  subject  is  laid  on  the  left  side  or  back  and  held  in 
that  position  by  an  assistant.  The  prepuce  is  pushed  back  behind  the 
swelling  of  the  gians  and  held  firmly  with  the  left  hand  (see  Fig.  70). 
Now  grasp  the  catheter  with  the  right,  of  course,  first  seeing  that  it 
has  been  well  lubricated  with  some  oil  or  cosmoline  and  that  it  contains 
the  wire-stylet,  and  introduce  it  into  the  urethra;  if  it  is  pushed  forward 
up  the  canal  and  meets  with  an  obstruction  at  the  posterior  end  of  the 
bone  of  the  penis,  it  is  due  to  a  flexure  of  the  canal  and  also  to  the  fact 
that  the  diameter  of  the  urethra  is  less  and  the  part  at  that  portion 
has  slight  contractile  properties.  By  a  gradual  pressure  the  stricture  is 
overcome  and  the  catheter  passed  upward  to  the  arch  of  the  perineum; 
here  the  wire-stylet  must  he  withdrawn  from  the  catheter  at  least  one- 
third,  so  as  to  allow  the  catheter  to  round  the  curve  of  the  ischial  arch;  a 


"  Fig.  70. — Passing  the  catheter. 

gradual  pressure  soon  brings  it  into  the  bladder,  when  the  wire  can  be 
removed  entirely. 

In  the  bitch  catheterization  is  very  difficult  at  times,  for  while  the 
instrument  should  be  introduced  along  the  middle  line  of  the  vestibule, 
freciuently  it  is  almost  impossible  to  find  the  narrow  opening  of  the 
urethra,  and  a  vaginal  speculum  is  sometimes  necessary  to  locate  the 
position  of  the  opening;  we  generally  use  a  metallic  catheter,  either 
silver  or  German  silver  (Fig.  71).  The  instrument  is  passed  up  on  the 
floor  of  the  vagina  until  it  comes  in  contact  with  the  urethral  opening 
(see  Fig.  72) ;  this  is  closed  with  a  slight  sphincter  (the  so-called  "urethral 
valve);  this  is  soon  overcome  and  the  catheter  passed  into  the  bladder 
without  difficulty,  except  in  cases  where  the  urethral  opening  is  extremely 
small. 


EXAMIXATIOX  OF  THE  PROSTATE 


171 


In  the  bitch  it  is  rare  that  an  examination  of  the  urethra  is  necessary, 
but  certain  discharges  from  the  vulva  are  of  diagnostic  vahie.  During 
the  period  of  "heat"  (menstruation),  which  occurs  normally  twice  a  year, 
in  June  or  July,  and  in  December  or  January  (this,  however,  is  not  a 
hard  and  fast  rule,  as  it  may  occur  in  April  or  May  and  November  or 
October),  we  have  a  copious  bloody  discharge,  and  during  the  preparatory 
stages  of  labor  we  see  a  thick,  clammy  discharge,  and  the  lochia  com- 


« 


Fig.  71.— 

Female  catheter. 


Fig.  72. — Median  section  through  the  pelvic  cavity;  a, 
rectum;  b,  vagina;  b',  vulva;  d,  bladder;  c  urethr;a  1,  pubic 
symphysis. 


mences  with  a  non-foetid,  serous,  slimy  discharge,  which  soon  changes 
to  a  thick,  yellowish  fluid.  Purulent,  putrid,  and  bad-smelling  discharges 
are  generally  found  in  inflammatory  or  ulcerative  discharges  from  the 
vagina  or  uterus.  It  may  also  be  observed  when  a  carcinoma  is  present. 
In  such  cases  it  is  best  to  introduce  a  mirror-speculum  into  the  vagina 
and  make  a  specular  examination.  The  instrument  to  use  is  the  so- 
called  two-valved  rectal  mirror  (Fig.  73).  Digital  examination  of  the 
vagina  is  often  productive  of  more  certain  diagnosis. 


Examination  of  the  Prostate. 

This  body  varies  in  size,  but  in  the  dog  it  is  large  in  comparison  to 
the  relative  size  in  other  animals,  varying  from  the  size  of  a  hazelnut 
to  that  of  a  walnut.  It  is  a  round,  ball-like  body  cut  into  two  portions, 
lying  on  the  neck  of  the  bladder  where  the  urethra  commences  (Fig.  74). 
It  lies  about  the  anterior  portion  of  the  pubic  bone,  and  being  free  to  a 
certain  extent,  it  can  be  pushed  into  the  abdominal  cavitj^  Avith  the  finger. 
In  hypertrophy  of  the  prostate,  we  find  a  painless  hard  body  varying 
from  the  size  of  a  walnut  to  that  of  a  small  orange.  Acute  prostitis  is 
extremely  painful   and  we  find  increased  local  temperature,  prostatic 


172      DISEASES  OF  THE  URIXARY  AND  SEXUAL  APPARATUS 

abscess  indicated  by  fever  and  fluctuation  of  the  prostate.  The  pros- 
tate may  be  covered  by  a  number  of  irreguhxr  knob-like  bodies,  in- 
variably painless  to  the  touch.  A  remarkable  diminution  of  an  enlarged 
prostate  invariably  follows  castration  in  the  male. 

Examination  of  the  Bladder. 

The  bladder  is  almost  entirely  covered  by  peritoneum  and  lies  just 
anterior  to  the  brim  of  the  pelvis,  or  in  some  cases  it  lies  entirely  in  the 
aljtlominal  cavity.  When  the  bladder  is  very  much  distended,  it  extends 
as  far  as  the  umbilicus  and  fills  up  the  lower  portion  of  the  abdomen. 


Fig.  73. — .Speculums.  Fig.   74. — Section    through  the  pelvis  of  the 

male:  1,  Bladder;  2,  opening  of  the  ureters  into 
the  bladder;  .3,  spermatic  ducts;  4,  prostate  gland; 
5,  urethra,  showing  Wilson's  muscle;  6,  arch  of 
the  urethera;  c,  pelvis. 

It  can  be  distinguished  by  manipvilation.  It  is  a  round,  distended,  tumor- 
like body,  giving  a  dull  sound  on  percussion.  On  examination  of  the 
rectum  we  not  only  feel  the  neck  of  the  bladder  and  the  prostate,  but 
the  bladder  itself  can  be  easily  distinguished.  Percussion  in  the  region  of 
the  bladder  when  it  contains  a  very  little  urine  or  is  empty  gives  a  hollow 
sound.  Tumor  or  stones  in  the  bladder  can  be  felt  by  pressing  down 
toward  the  wall  of  the  abdomen,  provided  the  bladder  is  empty  or  only 
partially  filled;  pain  on  pressure  in  the  region  of  the  bladder  indicates 
an  inflammatory  condition  of  the  bladder  (catarrh  of  the  bladder),  and 
in  this  condition  the  animal  evinces  more  or  less  pain  even  when  the  blad- 
der is  normally  distended  and  any  pressure  put  on  it. 


EXAMINATION  OF  THE  URINE  173 

Examination  of  the  Kidneys. 

The  kidneys  are  bean-shaped  and  are  almost  entirely  covered  by 
peritoneum;  they  lie  in  the  lumbar  region,  the  left  kidney  about  the  thir- 
teenth rib,  the  right  kidne}^  about  the  twelfth  rib;  posteriorly  the  kidneys 
extend  over  the  second,  third,  and  fourth  luml^ar  vertel)rpe;  in  rare 
instances  the  left  kidney  may  be  still  further  back,  both  kidneys 
lying  directly  opposite  each  other.  Frequently  they  are  readily  dis- 
tinguished by  manipulation  through  the  abdominal  walls,  and  espec- 
ially one  or  the  other  kidney  may  lie  free  from  its  attachments  or  be  ab- 
normally enlarged  during  life.  The  left  kidney  is  always  much  easier 
to  palpate  than  the  right.  The  best  position  is  to  have  the  animal  stand- 
ing, holding  the  thumb  on  the  vertebra  and  with  the  other  fingers  ma- 
nipulating the  abdominal  walls  until  the  outlines  of  the  kidneys  are 
recognized.  Pain  on  pressure  may  indicate  nephritis,  pyelonephritis, 
or  paranephritis;  enlargement  of  the  kidney  would  indicate  tumors,  ab- 
scesses, pyelonephritis,  hydronephrosis  or  purulent  nephritis;  abnormally 
small  kidneys  may  indicate  a  chronic  interstitial  nephritis.  Change  of 
the  position  or  remarkable  mol^ility  would  indicate  floating  or  migrating 
kidney. 

Examination  of  the  Urine. 

The  urine  has  to  be  examined  as  to  its  amount,  color,  transparency, 
reaction,  weight,  odor,  and  the  presence  of  certain  foreign  or  chemical 
substances. 

Amount  of  Urine. — The  amount  of  urine  passed  in  one  day  depends 
largely,  of  course,  on  the  size  of  the  animal,  the  cjuantity  of  fluids  it 
drinks,  and  the  temperature  of  the  atmosphere.  It  is  difficult  to  estimate 
the  exact  amount  of  urine  an  animal  A\'ill  pass  under  normal  circum- 
stances, as  one  animal  may  remain  indoors,  is  house-broken  and  retains 
his  urine  until  he  is  allowed  to  go  outside,  and  other  animals  that  are 
free  urinate  small  quantities  at  every  street  corner.  Friedberger  and 
Frohner  found  dogs  confined  in  cages  urinated  two  or  three  times  in 
twenty-four  hours,  but  the  amount  even  in  individuals  varies,  exercise 
having  great  influence  on  the  amount  excreted.  The  average  amount 
of  urine  passed  by  the  larger  kinds  of  dog  is  from  0.5  to  1.5  kilogrammes 
daily;  in  smaller  breeds,  one-half  that  amount.  An  increase  in  the  fre- 
quency of  the  act  of  urination  may  indicate  some  irritation  of  the  blad- 
der. A  decrease  in  the  amount  of  urine  passed  indicates  that  the  water 
of  the  body  is  being  taken  up  through  some  other  channel,  as  in  violent 
diarrhoea,  great  salivation,  during  the  formation  of  pleuritic  or  pcrito- 


174       DISEASES  OF  THE   URINARY  AND  SEXUAL  APPARATUS 

neal  exudates,  or  in  dropsy,  in  fevers,  in  decrease  of  the  pressure  of  the 
heart,  as  in  valvuhir  defects,  myocarditis,  etc.  An  entire  stoppage  of 
the  urine  may  occur  in  acute  or  subacute  inflammation  of  the  kichieys, 
in  o]:)struction  of  the  urethra,  paralysis  or  rupture  of  the  bladder,  from 
calculi  in  the  bladder  or  urethra,  from  stricture  of  the  urethra,  or  from 
swelling  and  pressure  of  the  prostate,  or  from  certain  poisons. 

An  increase  of  the  amount  of  urine  (polyuria)  may  be  clue  to  the 
presence  of  a  large  amount  of  water  in  the  blood  (anaemia,  hydrsemia), 
in  atrophy  of  the  kidney,  where  there  is  great  reabsorption  of  exudates, 
or  in  diabetes  mellitus  (a  condition  that  corresponds  to  diabetes  in- 
sipidus in  man).  This,  however,  is  extremely  rare  in  dogs.  We  may 
see  it  after  the  administration  of  the  different  diuretics.  It  is  frec][uently 
seen  in  convalescence  from  acute  diseases. 

Constant  driljbling  of  urine  indicates  paralysis  or  weakness  of  the 
blad<ler. 

The  Color  of  the  Urine. — This  varies  in  the  healthy  dog  from  pale 
yellow,  when  it  has  few  chemical  constituents,  to  dark  reddish-yellow 
when  it  is  concentrated  and  has  a  high  specific  gravity.  Food  also  has 
a  certain  influence  on  the  color.  After  eating  fat  it  is  reddish-yellow, 
and  after  meat  it  is  light  yellow;  after  eating  sugar  or  bread  it  is  dark 
yellow,  and  when  the  animal  is  starved  it  is  deep  yellow.  Disease  has 
also  a  great  effect  on  the  color.  It  is  a  deep  yellow  in  fevers  and  jDale 
or  colorless  in  diabetes  mellitus  or  insipidus  and  in  chronic  interstitial 
nephritis.  After  the  administration  of  diuretics  it  is  light  in  color,  and 
in  disease  of  the  liver  the  coloring  matter  of  the  bile  may  change  the  color 
of  the  urine  to  all  shades  of  yellow,  varying  from  lemon-yellow  to  deep  or 
even  brown-yellow  (see  icterus).  A  red  color  is  produced  by  the  coloring 
matter  of  the  blood,  general  angemia,  or  atrophy  of  the  kidneys;  a  green 
or  light  brown,  by  diseases  of  the  liver  and  catarrh  of  the  duodenum. 
Constant  dril)bling  or  slow  voiding  of  the  urine  without  any  apparent 
pain  (incontinentia  urina^)  indicates  weakness  or  paralysis  of  the  sphincter 
or  the  bladder  itself;  it  may  occur  from  certain  affections  of  the  spine, 
in  acute  cystitis,  or  from  tumors  of  the  bladder.  Difficult  or  painful 
urination  (dysuria,  retentio  urinse)  or  even  total  retention  of  urine  in- 
dicates urethral  calculus  or  certain  poisons.  Hsemoglobinuria  is  found  in 
piroplasmosis  and  following  the  administration  of  certain  of  the  febrifuges 
such  as  chlorate  of  potassium,  pyrogallol,  chrysarobin,  naphthol,  analine, 
kairin,  thallin,  acids,  etc.  Also  from  intense  burns,  occasionally  in 
septicaemia  and  in  infectious  hsemorrhagic  gastro-enteritis,  in  acute  cases 
of  distemper,  and  from  sudden  chills.  Rhubarb  and  senna  turn  the  urine 
yellow,  while  the  addition  of  an  alkali  turns  it  red.  Cascara  sagrada  turns 
the  urine  greenish-yellow,  santonin  and  cina  produces  a  red-yellow. 
Analine  also  produces  a  blood  red.     Xaphthalin  a  brownish-red;  carbolic 


EXAMIXATION  OF  THE  URINE 


175 


acid,  or  cresote,  salol,  resorcin  and  the  various  coal-tar  products  produce 
a  greenish-black  urine,  which  on  exposure  to  atmosphere  becomes  dark 
oilve-green.  Thallin  produces  a  bluish-green  urine  and  a  blue-red  is  pro- 
duced by  pyoctanin.  The  appearance  of  blood  in  the  urine  indicates- 
grave  conditions.  In  hsematuria  we  may  see  the  urine  like  blood,  the 
color  corresponding  to  the  number  of  blood  corpuscles  present,  and  in 
htemoglobinuria  the  coloring  matter  is  granular  or  dissolved  blood-coloring 
matter,  actual  blood  corpuscles  rarely  being  present,  the  urine  then  being 
dirty  reddish-brown  in  color.  Both  the  above  conditions  may  exist 
simultaneously  in  some  cases. 

Transparency  and  Reaction  of  the  Urine. — When  the  urine  has  been 
passed  recently  it  is  clear  and  transparent,  and  has  an  acid  reaction. 
After  feeding  with  bread  for  some  time  it  is  turbid  and 
alkaline.  After  feeding  with  fat  it  is  alkaline.  In  patho- 
logical conditions  when  the  urine  has  been  passed  recently 
it  is  turbid  and  filled  with  mucus  and  epithelium,  pus  cells, 
bacteria  or  triple  phosphates.  An  alkaline  reaction  gener- 
ally indicates  catarrh  of  the  bladder,  or  we  may  see  this 
condition  in  hsematuria,  in  reabsorption  of  exudates,  trans- 
udates, or  in  hemorrhage  into  the  abdomen  or  thorax. 

Odor  of  the  Urine. — There  is  a  slight  penetrating  odor 
in  normal  urine;  sometimes  it  is  slightly  garlicky.  Sul- 
phonal  produces  a  fruity  odor.  In  cases  of  catarrh  of  the 
bladder  the  urine  has  a  strong  ammoniacal  odor,  and  when 
any  amount  of  turpentine  has  been  absorbed  the  urine  has 
a  faint  smell  of  violets.  If  much  ammonia  is  present 
when  a  glass  rod  is  dipped  in  muriatic  acid  and  held 
over  the  urine,  a  white  cloud-like  vapor  arises  from  the 
urine. 

Specific  Gravity  of  the  Urine. — This  varies  in  the  dog 
between  10 IG  and  lOGO.  It  can  be  tested  by  means  of  the  urinometer 
or  if  we  have  only  a  small  quantity  we  can  test  it  readily  by  the  area- 
pikometer.  This  instrument  the  writer  has  found  to  be  very  useful.  It 
is  shown  in  Fig.  75.  Place  the  urine  to  be  tested  into  the  receptacle  C. 
Fill  it  full,  taking  care  that  there  are  no  air  bubbles  in  it.  Close  it  and 
then  sink  it  in  water  at  15°  R.  The  specific  weight  of  the  urine  will 
then  be  marked  on  the  scale. 

As  a  rule  it  will  be  found  that  dark  urine  has  a  high  and  light- 
colored  urine  a  low  specific  gravity.  But  there  are  exceptions  to  this, 
for  in  diabetes  mellitus  the  urine  is  clear  and  high  in  specific  gravity, 
while  in  nephritis  it  is  dark  in  color  and  has  a  low  specific  gravity. 
Dark  urine  seen  during  starvation  has  a  low  specific  gravity. 

Foreign  Substances  in  the  Urine. — The  following  substances  appear 


Fig.  75.— 
Areapikometer. 


17G      DISEASES  OF  THE  URIXARY  AND  SEXUAL  APPARATUS 

in  the  urine  under  pathological  circumstances.  jMucus,  blood,  particu- 
larly red  blood  corpuscles,  white  and  pus  corpuscles,  fat,  epithelium, 
and  tissues,  urinary  cylinders,  animal  and  vegetable  parasites,  crystals, 
albumen,  sugar,  or  coloring  matter  of  bile  and  indican. 

a.  Mucus  is  found  in  the  bladtler  under  all  conditions,  either  in 
health  or  disease  of  the  urinary  passages,  and  is  found  in  particularly 
large  fiuantities  in  catarrh  of  the  bladder. 

b.  Blood. — If  the  blood  is  mixed  in  the  urine  evenly  and  the  corpus- 
cles are  reduced  in  size  and  cylinders  are  present,  it  indicates  hemoi'rhage 
from  the  kidneys.  If  blood  is  present  it  is  called  hsematuria  and  when 
the  urine  is  stained  with  blood  or  blood-coloring  matter  it  is  called  hcemo- 
globinuria  or  methtemogloljinuria.  Heller's  test  or  the  spectroscope 
can  be  used  to  test  urine  for  blood  or  lilood  coloring  matter. 

Heller's  Test. — Add  to  the  sample  of  urine  a  solution  of  caustic 
sodium  or  potassium,  rendering  it  strongly  alkaline;  the  solution  is  then 


Jfct  Orange  t^elh 


^rim. 


A  aB    C       J)  E  b 

Fig.   76. — Spectrum  of  uriue  in  haemoglobinuria. 


Fig.   77  — Hsematin  crystals. 


l)rought  to  a  boiling  point,  and  a  flocculent  reddish-brown  deposit  is 
thrown  down. 

Spectroscope. — The  spectroscope  examination  is  made  by  means 
of  an  ordinary  pocket  spectroscope;  it  may  be  necessary  to  dilute  the 
urine  slightly  with  water  if  too  concentrated. 

Microscopical  examination  will  positively  determine  the  presence  of 
blood  cells. 

Hsematuria  is  indicated  by  the  presence  of  red  blood  corpuscles 
in  the  urine,  and  if  the  urine  has  been  allowed  to  stand  some  time  con- 
tracted or  broken  clown  blood  corpuscles  may  be  found  and  the  red 
coloring  matter  disappears.  This  condition  is  present  in  all  diseases  of 
the  kidneys. 

Hsematuria  is  found  in  all  diseases  of  the  kidneys,  acute  nephritis, 
acute  renal  stasis,  hemorrhagic  infarction,  travimatisms,  tumors  of  the 
kidneys,  diseases  of  the  urinary  passages,  particularly  the  pelvis  of  the 
kidney,  pyelitis,  nephrolithitis,  eustrongylus  gigas,  and  in  diseases  of 
the  bladder,  such  as  cystitis,  neoformations,  calculus,  inflammation  of 
the  prostate  and  urethra. 

The  location  of  the  hemorrhage  may  be  indicated  in  the  following 


EXAMINATION  OF  THE  URINE  177 

manner.  If  from  the  kidney,  by  the  presence  of  large  quantities  of  epithe- 
lium and  cylinder  casts,  while  the  absence  of  casts  and  the  presence  of  epi- 
thelium peculiar  to  the  bladder,  would  indicate  it  came  from  that  organ. 
If  the  urine  is  bloody  at  irregular  intervals,  it  indicates  hemorrhage  from 
the  pelvis  of  the  kidney.  When  the  blood  is  not  mixed  with  the  urine, 
but  comes  down  in  a  mass,  the  diseased  condition  must  be  in  the  blad- 
der. This  indication  is  not  always  certain,  as  we  may  see  the  blood 
evenly  mixed  with  the  urine  in  diseased  conditions  of  the  bladder,  such 
as  cystitis.  When  the  blood  is  passed  just  before  the  urine  or  follows 
after  the  last  of  the  urine  has  passed,  or  is  passed  involuntarily,  it  indi- 
cates hemorrhage  from  the  prostate  or  urethra.  Haematuria  may  re- 
sult from  certain  infections  or  constitutional  diseases,  or  as  a  result  of 
the  presence  of  certain  filaria  in  the  blood. 

c.  White  Blood  Corpuscles,  Pus. — White  blood  corpuscles  are  found 
in  the  urine  and  are  found  associated  with  red  blood  cells;  they  are  also 
found  in  the  majority  of  diseases  of  the  kidneys  and  urinary  organs. 
When  a  considerable  quantity  of  pus  is  passed,  it  indicates  the  opening 
of  an  abscess  in  the  prostate.  When  a  smaller  quantity  is  present  it 
indicates  the  presence  of  some  inflammation  of  the  mucous  membranes 
of  the  kidneys.  We  can  obtain  definite  information  as  to  this  con- 
dition by  making  a  microscopical  examination  of  the  epithelium  to  see 
whether  any  cylinders  are  present  or  not. 

d.  Fat  may  be  seen  in  drops  on  the  surface  of  the  urine  or  shortly 
after  it  has  been  passed.  In  very  fat  animals  this  may  be  seen  as  a 
normal  condition,  and  where  animals  have  had  large  quantities  of  fat 
given  to  them.  It  also  indicates  the  fatty  degeneration  of  epithelium 
of  the  kidneys.  Friedberger  and  Frohner  have  seen  a  pathological 
lipuria  associated  with  croupous  pneumonia  in  animals  with  certain 
anemic  and  cachectic  conditions.  It  is  also  present  in  the  various  dis- 
eases of  the  kidneys.  Do  not  be  misled,  when  you  have  passed  a  well- 
lubricated  catheter  and  see  oil  floating  on  the  urine,  into  thinking  that 
it  is  a  pathological  condition. 

e.  Epithelium  and  Broken-down  Tissue. — In  health  a  few  epithelial 
cells  are  always  passed,  but  when  they  are  present  in  large  quantities 
it  indicates  some  active  inflammation  going  on  in  some  part  of  the  uri- 
nary tract,  and  a  microscopical  examination  of  the  cells  to  ascertain 
their  size  and  shape  will  indicate  the  section  of  the  urinary  system  they 
come  from.  Large  quantities  of  squamous  epithelium  indicate  an  irri- 
table condition  of  the  bladder,  but  it  may  also  come  from  the  uterus  or 
pelvis  of  the  kidney.  Renal  epithelium  in  any  quantity  indicates  disease 
of  the  kidney;  large  quantities  of  glandular  cells,  mixed  with  pus  corpus- 
cles and  dumb-bell  bacteria,  indicate  disease  of  the  prostate.  Broken- 
down  tissues  in  the  urine  indicate  renal  tumors,  suppurative  or  septic 

12 


178      DISEASES  OF  THE  URINARY  AND  SEXUAL  APPARATUS 

nephritis,  severe  inflammatory  processes,  or  carcinoma  of  the  bladder  or 
prostate  (Fig.  78). 

/.  Renal  Cylinders. — "Where  we  find  hyaline  cylinders,  granular 
cylinders,  epithelial  cylinders,  or  blood  casts,  then  we  can  feel  assured 
that  there  is  some  disease  of  the  kidneys.  Blood  cylinders  indicate 
hemorrhage  of  the  kidneys.  Epithelial  cells  in  large  numbers  indicate 
great  desquamation  of  the  epithelium,  as  in  acute  parenchymatous  neph- 


FiG.  78. — Epithelium  found  in  the  urine:  a,  From  the  bladder;  b,  from  the  ureters;  c,  fromthe  pelvis  of 

the  kidney. 

ritis.  Hyaline  or  epithelial  cells  when  mixed  with  pus  cells  indicate 
suppurative  nephritis.  Hyaline  and  granular  cells  are  present  in  all 
diseases  of  the  kidneys  and  always  in  albuminuria  and  fevers  (Fig.  79), 
g.  Vegetable  and  Animal  Parasites. — Vegetable  parasites  may  be 
found  in  recently  voided  urine  in  the  form  of  the  split  fungus,  side  by 
side  with  triple  phosphates  (Fig.  80).  Siedamgrotzky  found  numerous 
ball  bacteria  and  pus  corpuscles  in  suppuration  of  the  prostate.     Animal 


Fig. 


79. — Uric  cylinders;  a.  Hyaline  cylinders;  h,  epithelial  cylinders;  d,  granular  cylinders;  c,   blood 

cylindera. 


parasites  may  l^c  found,  either  the  eggs  of  the  eustrongylus  gigas  or  the 
eml;)ryonic  forms  of  the  filaria  immitis. 

h.  Crystals. — We  find  collections  of  precipitates  in  the  urine  and  in- 
dications of  alkaline  fermentation,  the  urine  being  alkaline  in  reaction 
and  containing  crystals  of  triple  phosphate,  phosphoric  acid  and  am- 
moniacal  magnesia;  these  crystals  develop  in  ammoniacal  urine  and  are 
coffin-shaped,  they  arc  soluble  in  acetic  acid,  thus  being  distinguished 


EXAMIXATION  OF  THE   URINE  179 

from  calcium  oxalate,  and  occur  in  large  quantities  in  chronic  cystitis. 
There  are  a  numl_)er  of  abnormal  substances  found  in  the  urine.  The 
principal  ones  are  albumin,  sugar,  and  the  coloring  substances  of  the 
bile. 

i.  Albumin. — The  presence  of  albumin  in  the  urine  is  always  an 
indication  of  disease.  The  two  most  important  forms  of  albumin  are 
serum-albumin  and  serum-globulin;  the  two  are  generally  in  combina- 
tion, and  both  give  the  same  reaction. 


Fig.   80.— Urine  of  a  dog  with  cystitis,  triple  phosphate  crystals,  red  and  white  blood  corpuscles,  and 

cystic  epithelium.     Bacteria. 

Koch's  Test. — The  urine  to  be  examined  must  be  carefully  filtered 
before  proceeding  with  the  test.  The  urine  is  boiled  in  a  test-tube,  hav- 
ing been  previously  rendered  acid  in  reaction  by  the  addition  of  a  small 
quantity  of  acetic  acid.  The  urine  may  become  opaque  from  two  causes; 
from  the  presence  of  albumin  or  from  phosphates;  to  this  we  add  nitric 
acid  drop  by  drop  until  the  phosphate  is  all  dissolved  and  the  albumin 
remains  opaque. 

Heller's  Test. — The  urine  is  rendered  acid;  then  pour  a  small  quan- 
tity of  nitromuriatic  acid  down  the  side  of  the  tulje,  and  if  there  is  any 
albumin  present  there  will  be  a  pronounced  opaque  ring  or  line  where 
the  acid  meets  the  urine. 

Test  with  Acetic  Acid  and  Ferrocyanide  of  Potassium. — The  urine  is 
rendered  acid  with  acetic  acid  and  drop  by  drop  a  5  to  10  per  cent,  solution 
of  ferrocyanide  of  potassium  is  added;  if  albumin  is  present,  a  white 
turbidity  indicates  the  presence  of  albumin.  If  the  solution  immedi- 
ately becomes  turbid  on  the  addition  of  a  very  small  quantity  of  the  solu- 
tion it  is  due  to  the  presence  of  mucin  and  must  be  filtered  immedi- 
ately before  proceeding.  Very  concentrated  urine  must  be  diluted  with 
a  certain  quantity  of  water.  The  quantitative  test  for  albumin  must 
be  made  by  means  of  an  albuminometer;  if  this  is  required  the  methods 
described  in  text-books  on  analytical  chemistry  should  be  consulted;  as 
a  rule  the  simple  proof  of  the  presence  of  albumin  is  sufficient  for  diag- 
nostic purposes. 


180      DISEASES  OF  THE  URINARY  AND  SEXUAL  APPARATUS 

A]])innin  occurs  in  the  urine  from  two  causes:  in  false  or  accidental 
albuminuria,  and  in  true  or  renal  all)uminuria. 

The  first  occurs  when  there  is  free  albumin  in  the  urine  from  ac- 
cidental causes,  as  where  the  albumin  is  added  to  the  urine  in  its 
passage  from  hemorrhage,  inflammatory  conditions  in  the  passages, 
or  from  purulent  inflammations.  In  such  cases  the  microscope  will 
easily  make  the  differential  diagnosis.     The  quantity  is  always  small. 

True  all)uminuria  is  of  much  greater  importance,  as  this  condition 
is  always  a  symptom  of  pathological  alterations  in  the  epithelium  cover- 
ing the  walls  of  the  gland.  Healthy  epithelium  wall  always  retain  the 
albumin  in  the  blood. 

We  see  true  albuminuria  in  all  forms  of  acute  and  chronic  inflamma- 
tion of  the  kidneys,  in  fatty  degeneration  of  the  kidneys,  in  amyloid 
kidneys,  and  in  any  altered  condition  of  the  renal  circulation,  such  as 
stagnating  hypei'semias  as  a  consequence  of  heart  disease,  and  in  chronic 
inflammatory  conditions  of  the  lungs,  pleuritis,  hydrothorax.  The 
horizontal  position  of  the  dog  does  not,  however,  cause  such  a  great  dis- 
turbance in  the  posterior  extremities  when  the  smaller  blood  vessels 
are  congested  as  it  docs  in  man. 

Albumin  will  sometimes  be  found  in  the  blood  from  ansemia,  leu- 
kaemia, in  acute  poisoning,  and  from  high  fevers,  acute  infectious  diseases, 
or  violent  muscular  exertion.  In  acute  nephritis  a  large  amount  of  albu- 
min is  found  to  be  present,  in  smaller  quantity  in  chronic  nephritis,  while 
in  acute  atrophy  of  the  kidney  very  little  albumin  may  be  found,  but 
in  the  latter  condition  we  generally  find  that  there  is  present  more  or 
less  nephritis  or  a  slight  parenchymatous  degeneration  of  the  kidneys. 
And  it  is  well  to  examine  the  urine  under  the  microscope  to  see  if  cylin- 
ders are  present. 

Sugar. — The  grape-sugar  test  is  generally  made  when  an  animal  has 
a  good  appetite  and  polyuria  and  yet  becomes  generally  emaciated,  and 
when  the  urine  is  pale  but  of  a  high  specific  gravity. 

The  tests  are  Trommcr's,  the  bismuth,  and  the  fermentation  test. 

Trommer's  Test  for  Sugar. — Put  a  few  c.c.  of  urine  in  a  reagent  glass, 
taking  care  to  first  see  that  there  is  no  albumin  in  it,  and  if  so  coagulate 
it  and  filter  it  out.  Take  the  urine  and  dilute  it  with  an  equal  bulk  of 
water,  and  render  it  alkaline  with  a  small  quantity  of  sodium  hydrate; 
then  add  drop  by  drop  a  4  per  cent,  solution  of  cupri  sulphas  until  the 
li(piid  is  clear  and  the  sediment  dissolved,  then  heat  it  until  it  boils, 
and  if  sugar  is  present  we  see  a  reddish-yellow  vapor  appear  at  the  sur- 
face of  the  fluid. 

Bismuth  Test. — Ten  parts  of  urine  from  which  all  albumin  is  re- 
moved has  the  following  solution  added  to  it:  bismuth  sul^nitrate  2  parts, 
Rochelle  salt  4  parts,  and  a  hundred  parts  of    10  per  cent,  solution  of 


ACUTE  INFLAMMATION  OF  THE  KIDNEYS  181 

caustic  soda;  this  mixture  is  boiled  five  minutes,  and  if  sugar  is  present 
the  mixture  becomes  bhick. 

Fermentation  Test. — This  test  is  always  to  be  preferred  in  dul^ious 
cases;  it  is  also  useful  to  determine  the  quantity  of  sugar  present.  In 
this  test  the  saccharometer  is  used.  The  method  consists  in  adding  a 
small  quantity  of  yeast  to  a  certain  proportion  of  urine;  for  further  de- 
tails the  reader  is  referred  to  works  on  the  chemical  analysis  of  urine. 

In  diabetes  mellitus  a  large  quantity  of  sugar  is  generally  found 
in  the  urine.  This  disease,  however,  is  extremely  rare  in  the  dog.  It 
is  also  found  when  the  animal  has  been  fed  on  a  pure  sugar  diet.  A  con- 
siderable amount  of  sugar  has  been  found  in  the  urine  of  bitches  that 
were  nursing,  especially  when  the  pups  were  prevented  from  nursing 
for  some  time.  The  writer  cannot  say  whether  it  is  found  in  the  dog 
in  certain  cases  of  poisoning,  or  from  some  neurotic  causes. 

Coloring  Substance  of  the  Bile. — The  coloring  substances  of  the  bile 
are  found  quite  frequently  in  the  urine  of  the  dog.  The  presence  of 
these  indicates  an  obstruction  in  the  excretion  of  bile.  It  may  often  be 
seen  in  catarrh  of  the  intestines  and  in  the  gastric  form  of  distemper. 
Icterus  is  the  most  common  cause  of  this  condition.  (For  further  in- 
formation, see  icterus.)  Frohner  found  this  also  in  neurosis  and  bronchial 
forms  of  distemper,  in  some  diseases  of  the  kidneys,  in  pleuritis,  and  in 
great  heart  weakness.  Voigt  also  found  it  in  animals  that  were  starved. 
Bile  acids  in  the  urine  are  of  no  diagnostic  value  in  the  dog,  and  will  not 
be  taken  up  in  this  work. 


DISEASES  OF  THE  KIDNEYS. 
Inflammation  of  the  Kidneys;  Nephritis. 

It  is  impossible  to  accurately  separate  the  different  inflammatory 
conditions  of  the  kidneys,  and  as  a  rule  it  is  only  on  post-mortem  that 
the  condition  can  be  properly  diagnosed.  Consequently,  the  practi- 
tioner has  to  be  satisfied  if  he  can  recognize  with  certainty  that  the  pnimal 
has  some  affection  of  the  kidneys,  and  whether  it  is  acute  or  chronic. 
In  the  dog  it  is  only  in  chronic  nephritis  that  we  find  a  general  atrophy 
of  the  kidney. 

Acute  inflammation  of  the  kidney  may  be  traced  to  severe  cold, 
to  traumatisms,  or  to  sympathetic  irritation  from  adjacent  organs,  or 
to  acute  catarrh  of  an  infectious  or  toxic  character. 

The  diseases  of  the  kidneys  in  the  dog  do  not  pos-<\''^  that  impor- 
tance that  they  do  in  man. 


182      DISEASES  OF  THE  URIXARY  AND  SEXUAL  APPARATUS 

Acute  Inflammation  of  the  Kidneys. 

(Acute  Nephritis;  Nephritis  Acuta.) 

Etiology. — The  most  common  causes  of  this  condition  are  infec- 
tious diseases  and  poisons.  By  this  is  meant  the  effect  produced  l)y 
the  absorption  of  infectious  noxious  agents,  such  as  the  various  septic 
cUseases,  or  certain  irritants  that  have  originated  in  the  body  and  are 
passed  into  the  kithieys  and  cause  great  irritation  while  they  are  passing 
through  these  organs,  and  also  certain  micro-organisms  that  reach  the 
blood  and  become  located  in  the  capillaries  of  the  kidneys.  Certain 
chemical  substances,  such  as  phosphorus,  arsenic,  lead,  mercury,  copper, 
cantharides,  turpentine,  colchicum,  male  fern  extract,  strong  spices, 
carbolic  and  tar  acids,  naphthol,  and  chrysarobin,  that  are  absorbed  or 
taken  into  the  stomach  pass  through  the  kidneys  and  cause  great  inita- 
tion.  Some  of  these  chemical  substances  are  absorbed  by  the  skin 
from  various  ointments  that  are  applied  in  mange,  such  as  carbolic  acid, 
mercury,  cantharides,  balsam  of  peru,  storax,  etc. 

Acute  nephritis  may  also  originate  from  an  extension  of  inflamma- 
tion from  neighboring  organs,  and  also  from  traumatic  influences,  such 
as  blows,  shocks,  etc.,  in  the  regions  of  the  kidneys.  There  is  a  condition 
called  rheumatic  inflammation  of  the  kidneys  that  is  supposed  to  origi- 
nate from  cold.  This  occurs  generally  in  young  dogs  during  severely 
cold  weather. 

Pathological  Anatomy. — The  alterations  in  the  structure  of  the 
kidney  depend  on  the  intensity  of  the  irritation,  and  the  alterations 
are  more  or  less  distinctly  marked.  In  slight  cases  the  epithelium  seems 
to  be  the  only  part  affected,  the  connective  tissue  and  the  blood  vessels 
show  no  pathological  alteration  other  than  a  reddish-gray  coloration 
of  the  covering,  or  sometimes  a  yellowish  coloration  (parenchymatous 
degeneration).  AMien  the  irritation  is  great,  there  is  true  parenchyma- 
tous inflammation  of  the  kidneys.  The  epithelium  and  the  inter- 
mediate tissue  become  affected,  as  do  the  blood  vessels,  and  all  the 
exudation  processes  which  accompany  acute  nephritis  follow.  The 
anatomical  alterations  that  are  fovmd  are  as  follows:  The  epi- 
thelium has  undergone  extensive  desquamation,  as  in  parenchyma- 
tous degeneration,  Ijut  more  acute  in  its  type.  The  capsules  of  the  glom- 
eruli and  the  small  urinary  canals  are  altered,  and  the  connective  tissue 
is  filled  with  a  liquid  infiltration  forming  numerous  coagulated  masses 
containing  large  numbers  of  Icukoc^'tes  rich  in  hydrogen  and  the  urinary 
canaliculi  are  filled  with  hyaline  and  epithelial  cylinders.  The  vessels 
are  enlarged  (hypenemic)  and  partially  compressed  by  the  surrounding 


ACUTE  IXFLAMMATION  OF  THE  KIDNEYS  183 

exudates.  In  the  interstitial  tissue  and  in  MuUer's  capsule  we  find  small 
circumscribed  hemorrhages.  There  are  a  number  of  circular-shaped 
inflammatory  centres  surrounded  by  liquid  exudates. 

The  inflamed  kidney  may  present  a  variety  of  different  appearances. 
It  ma}"  be  enlarged  or  normal  in  size,  soft  or  hard,  reddened  or  very  pale 
or  yellowish-white,  and  on  the  surface  of  the  kidney  there  may  be  found 
a  number  of  hemorrhage  spots  that  are  slightly  elevated  from  the  sur- 
face of  the  gland.  The  capsule  can  easily  be  stripped  from  the  body  of 
the  kidney.  There  are  certain  forms  of  acute  nephritis  and  glomerulo- 
nephritis that  present  so  little  visible  changes  that  they  may  escape  the 
eye  of  the  non-experienced  practitioner.  Concerning  more  accurate  de- 
tails refer  to  the  variovis  text-books  on  pathological  anatomy,  particu- 
larly Kitt,  who  has  made  a  special  study  of  the  pathological  anatomy 
of  domestic  animals. 

Clinical  Symptoms  and  Course. — Slight  inflammatory  conditions 
of  the  kidneys  are  rarely  recognized  in  the  dog,  as  the  only  diagnostic 
points  are  to  be  found  on  examination  of  the  urine.  This  contains  a 
small  amount  of  albumin,  some  hyaline  cylinders,  and  a  few  epithelial 
cells  and  leukocytes. 

In  acute  inflammatory  conditions  the  animal  has  a  peculiar  stiff 
gait  in  w^alking,  and  in  some  cases  staggering,  with  the  hind  legs  carried 
straight,  and  tenderness  on  pressure  in  the  regions  of  the  loins;  there 
may  be  pain  on  pressure  in  the  region  of  the  kidneys,  and  an  exact  knowl- 
edge of  the  anatomy  will  aid  to  discover  whether  these  organs  are  enlarged; 
a  quick  full  pulse,  with  loss  of  appetite,  and  persistent  vomiting  in  the 
early  stages  of  the  disease;  great  lessening  in  the  amount  of  urine  se- 
creted, and  what  is  passed  is  dark  in  color  and  contains  small  portions  of 
coagulated  blood,  but  the  animal  may  make  frequent  attempts  to  uri- 
nate, and  the  faeces  are  dry  and  hard.  The  amount  of  urine  passed  in  such 
conditions  is  small  and  contains  a  large  amount  of  albumin.  The  urine 
is  turbid,  reddish-brown  to  dark  red  in  color;  if  allowed  to  stand  there  is 
a  thick  nuicus-like  sediment  of  a  red-brown  or,  in  rare  cases,  opaque 
red  color,  and  the  specific  gravity  is  greatly  increased;  examined  micro- 
scopically, it  is  found  to  contain  numerous  tube-cylinders,  epithelium, 
and  white  blood  corpuscles,  also  red  blood  corpuscles,  which  give  the 
urine  a  variable  color,  according  to  the  number  of  corpuscles  present; 
chemically  tested,  large  quantities  of  albumin  are  found  to  be  present. 
There  is  generally  more  or  less  pain  on  urination;  this  is  probably  due  to 
the  acrid  condition  of  the  urine.  There  are  also  present  more  or  less 
symptoms  of  uraemia,  with  great  weakness,  fatigue,  and  temperature 
generally  subnormal,  the  pulse  weak  and  thready,  vomiting,  dian-hcea, 
oedema  of  the  lim1)s,  convulsions,  coma,  and  death.  The  result  in  an 
acute  case  is  not  often  favorable  if  the  disease  lasts  from  8  to  14  days. 


184       DISEASES  OF  THE   URINARY  AND  SEXUAL  APPARATUS 

AVhen  the  symptoms  are  milder  and  the  animal  recovers,  this  is  indi- 
cated by  an  increase  in  the  amount  of  urine  secreted  and  its  becoming 
clearer;  liut  this  condition  may  be  followed  by  chronic  nephritis. 

Therapeutics. — Medicine,  as  a  rule,  has  little  or  no  effect  on  these 
cases.  Tannin,  0.1  gm.  several  times  daily;  tinct.  fol.  uvaursi,  1.0.,  or 
fuchsin,  and  iron  preparations  may  all  be  used. 

The  dietetic  treatment  is  the  most  successful  and  consists  principally 
of  rest  and  food  that  is  non-in-itating  to  the  kidneys,  such  as  milk, 
mutton  broth,  rice  and  gelatine  soups,  are  especially  useful.  Meat 
may  be  given,  in  the  acute  stages,  but  only  lean  meat  and  in  spare 
quantities,  avoiding  anything  that  is  spiced  or  salted.  The  symp- 
tomatic treatment  is  to  try  to  lessen  the  strain  thrown  on  the  kid- 
neys by  trying  to  carry  the  fluids  out  of  the  body  by  some  channel 
other  than  the  kidneys,  and  we  try  to  do  this  through  the  skin  or  the  in- 
testines. This  can  be  accomplished  to  a  certain  extent  by  giving  the 
animal  hot  baths  or  using  warm  bandages  (the  Priessnitz  compress) 
around  the  body,  particularly  around  the  kidneys,  and  also  by  active  pur- 
gatives which  have  no  action  on  the  kidneys,  such  as  cascara  sagrada,  also 
jalap  and  calomel.  Where  there  is  great  pain  in  the  region  of  the  kidney 
and  the  animal  moves  about  Avith  the  back  arched,  the  application  of  a 
warm  linseed  poultice  in  the  region  of  the  kidneys  is  particularly  useful. 
To  relieve  the  kidney  we  can  also  try  pilocarpine,  which  produces 
great  salivary  secretion  in  the  dog.  This,  however,  must  be  used  with 
great  care  in'dogs  that  have  any  affections  of  the  heart  or  lungs.  Diuretics 
must  not  be  used  in  nephritis,  as  they  increase  the  secretion  of  salts, 
especially  the  alkalies.  General  debility  should  be  treated  by  alcoholic 
stimulants,  such  as  brandy,  whiskey,  or  sherry,  in  the  case  of  very  small 
animals.  Use  inhalations  of  chloroform,  clysters  of  chloral  hydrate,  or 
salts  of  bromine  to  counteract  convulsions.  Where  acute  nephritis  occurs 
as  a  result  of  some  infectious  or  toxic  disease,  the  symptoms  must  be 
treated  in  connection  with  the  exciting;  cause 


Chronic  Inflammation  of  the  Kidneys. 

(Chronic  Nephritis;  Xephritis  Clironica.) 

Etiology. — Chronic  nephritis  oi'iginates,  as  a  rule,  from  acute  nephritis 
or  starts  in  a  mild  form  and  gradually  becomes  chronic;  this  is  seen  particu- 
larly when  it  originates  from  toxic  or  infectious  causes,  and  in  animals 
that  are  subjected  to  repeated  colds  or  lie  in  damp  kennels,  so  that  it  is 
very  difficult  to  tell  at  times  just  how  a  chronic  case  may  originate. 

Pathological  Anatomy. — There  are  two  forms  of  chronic  inflammation 
of   the  kidneys;  first  the  large  white  kidney    (chronic  parenchymatous 


CHRONIC  INFLAMMATION  OF  THE  KIDNEYS  185 

nephritis),  and  the  atrophic  or  hard  kidney  (chronic  interstitial  nephritis). 
The  first  contlition  is  generally  the  forerunner  of  the  second,  but,  as  the 
hard  kidney  is  most  frequently  found  in  post-mortem,  it  is  possible 
that  it  niaj'  develop  as  a  primary  condition.  The  white  kidney  is  en- 
larged from  the  normal  size,  and  has  a  smooth  yellow  or  irregular  yellow- 
colored  surface.  The  cortical  portion  is  yellowish  in  color,  while  the 
pyramids  are  red.  In  some  cases  we  find  the  kidney  large  and  red,  or  al- 
ternated red  and  yellow,  or  covered  with  hsemorrhagic  spots.  The 
atrophic  kidney  (shrunken  or  contracted  kidney)  results  from  an  increase 
of  the  interstitial  substance  and  atrophy  of  the  parenchymatous  substance. 
It  is  hard  and  tough  on  its  surface,  and  has  small,  wart-like  irregularities 
and  granulations.  The  capsule  is  thickened  and  it  is  hard  to  strip  from  the 
body  of  the  kidney;  here  and  there  we  find  small  cysts  of  various  sizes. 
The  cortical  substance  is  lessened  in  diameter  and  striated  wdth  layers  of 
dark  colored  tissue.     The  pyramids  are  smaller  and  deep  red  in  color. 

Clinical  Symptoms  and  Course.  — As  a  rule,  very  little  that  can  be  recog- 
nized in  the  clog  during  life.  The  quantity  of  urine  passed  is  greatly  in- 
creased and  at  much  shorter  intervals;  this  increase  of  the  amount  of 
urine  passed  is  one  of  the  first  symptoms  to  attract  the  attention  of  the 
owner.  The  urine  is  very  light  in  color,  almost  like  water,  the  specific  grav- 
ity being  much  lessened.  Microscopically  examined,  we  may  find  iso- 
lated hyaline  cylinders,  and  a  few  blood  corpuscles;  albumin  is  never  present 
in  any  great  amount,  frequently  for  a  certain  period  small  quantities  of 
albumin  may  be  present  and  then  it  entirely  disappears.  Palpation  of  the 
kidney  may  find  it  hard,  and  uneven  on  the  surface.  In  such  cases  there 
is  generally  hj-pcrtrophy  of  the  left  ventricle,  which  can  be  recognized 
by  palpitation  of  the  heart  (loud  pulsations  and  a  hard,  full  pulse).  It 
is  presumed  that  this  high  arterial  pressure  tends  to  keep  up  the  action 
on  the  impaired  kidney  and  prevent  any  serious  disturbance  in  the  secre- 
tion of  the  kidney.  As  the  disease  advances  we  soon  recognize  a  change: 
the  heart  becomes  weaker  in  its  action,  the  pulse  is  small  and  frequent,  the 
urine  is  scant,  dark  and  very  albuminous.  This  is  followed  by  chronic 
inflammatory  processes  in  various  organs,  especially  the  bronchia,  and  in 
the  intestinal  canal;  and  finally  we  have  symptoms  of  uraemia.  In  the 
majority  of  cases  the  parenchymatous  form  can  be  recognized  by  the 
urine.  This  is  very  similar  to  acute  nephritis.  It  contains  much  albu- 
min, and  the  urine  is  scant  in  quantity,  and  there  are  certain  dropsical 
symptoms  in  the  dependent  regions;  death  may  occur  as  a  result  of  gen- 
eral dropsy  or  uraemia,  or  such  complications  as  pneumonia,  pleurisy,  or 
pericarditis.  There  is  also  loss  of  appetite,  great  fatigue  on  taking  any 
exercise,  hypertrophy  of  the  heart,  which  finally  becomes  weak,  and  then 
symptoms  of  ursmia  follow  as  stated  above.  In  rare  cases  the  condition 
may  change  and  the  active  symptoms  cease;  the  urine  gradually  becomes 


18G       DISEASES  OF  THE   URINARY  AND  SEXUAL  APPARATUS 

clean  and  of  a  lighter  specific  gravity,  it  increases  in  quantity  and  the 
dropsical  regions  return  to  their  normal  condition. 

Therapeutics. — The  treatment  of  chronic  nephritis  is  the  same  as  in 
acute.  As  the  course  of  the  disease  generally  covers  a  long  period  and  the 
affected  animal  suffers  great  loss  of  strength,  the  animal  must  be  fed  fre- 
quently on  milk,  rice,  or  meat,  being  careful  to  use  no  salt  or  spices.  But  the 
dropsical  conditions  can  be  treated  by  diuretics  and  aromatics;  pilocarpin 
is  also  sometimes  used,  and  when  there  is  great  anaemia  give  iron  salts  to 
assist  absorption  of  the  pathological  neoformation  resulting  from  the  in- 
flammatory processes.  Iodine,  iodide  of  potassium,  or  sodium  may  l)e 
administered. 

Other  Diseases  of  the  Kidneys. 

There  are  in  the  dog  a  number  of  pathological  conditions  of  the  kidneys 
Avhich  are  of  very  little  importance;  the  most  important  of  these  will 
here  be  described  briefly. 

Renal  Hyperaemia. — This  follows  as  a  result  of  arterial  hypersemia  and 
may  be  produced  by  the  same  causes  as  produced  acute  nephritis;  fre- 
quently certain  diseases  of  the  circulatory  or  respiratory  organs,  interfer- 
ing with  the  venous  circulation,  produce  passive  hypersemia  of  the  kidneys 
(renal  stasis).  Thrombus  in  the  renal  circulation  or  tumors  pressing  on 
the  vessels  may  also  cause  it.  In  renal  congestion  there  is  a  large  amount 
of  urine  secreted,  which  is  light  in  color  and  of  a  low  specific  gravity, 
whereas  in  renal  stasis  the  urine  is  of  high  specific  gravity,  dark  in 
color  and  contains  a  certain  amount  of  albumin,  hyaline,  cylinders  and 
blood  corpuscles  in  small  amount.  The  urine  after  standing  some  time 
forms  a  thick  red  precipitate  of  urates,  which  are  readily  redissolved 
by  heat. 

The  treatment  consists  in  endeavoring  to  remove  the  active  ca\ise  of 
the  hypersemia  by  treating  the  primary  affection. 

Amyloid  Kidney. 

Amyloid  kidney  gcncrall}'  occurs  in  connection  with  amyloid  degenera- 
tion of  some  other  organs  of  the  body.  The  kidney  is  slightly  increased  in 
volume,  firm,  smooth,  with  yellowish-white  coloration  of  the  cortex,  and 
in  the  parenchymatous  form  the  condition  can  usually  be  recognized  by 
the  character  of  the  urine.  This  generally  presents  the  same  symptoms  as 
those  of  acute  nephritis.  The  urine  is  loaded  with  albumin  and  much 
lessened  in  quantity. 

The  amyloid  condition  is  seen  not  only  in  the  kidneys,  but  also  in 
the  liver,  pancreas,  and  intestines. 


ABSCESS  OF  THE  KIDNEYS  187 

Pathological  Anatomy. — A  kidney  thoroughly  affected  with  amjdoid 
disease  is  slightly  enlarged,  hard,  smooth,  and  shows  at  the  intersections  a 
deep  yellowish-white  coloration,  easily  distinguished  on  section.  The 
glomeruli  are  easily  distinguished  with  the  naked  eye  as  small  glossy  spots. 
On  staining  with  Lugol's  solution  the  affected  parts  are  colored  a  mahog- 
any-brown and  with  methyl  are  colored  purple-red.  For  further  details 
see  works  on  pathological  anatomy. 

Clinical  Symptoms. — The  extremities  are  dropsical,  with  complete 
loss  of  appetite,  coma,  uraemia,  and  then  death.  In  a  case  where  the  ani- 
mal was  unsteady  and  weak,  with  paleness  of  the  mucous  membrane,  Zim- 
merman found  an  amyloid  kidney  associated  with  hypertrophy  of  the 
left  side  of  the  cord. 

Therapeutics. — The  treatment  consists  in  following  what  is  prescribed 
in  nephritis. 

Abscess  of  the  Kidneys. 

(Suppurative  Nephritis;  Pyelonephritis.) 

Etiology. — The  direct  cause  of  the  formation  of  abscess  of  the  kidney 
is  direct  injury  of  the  kidneys  or  in  the  region  of  them,  causing  the  forma- 
tion of  purulent  abscess  in  the  urinary  passages,  the  bladder,  the  urethra, 
or  the  pelvis  of  the  kidney.  In  certain  cases  this  condition  is  associated 
with  ulcerous  endocarditis,  from  the  results  of  an  embolus  which  may  be 
liberated  and  get  into  the  circulation. 

Pathological  Anatomy. — Purulent  nephritis  occurs  in  various  forms, 
according  to  its  origin.  When  this  condition  is  caused  by  an  embolus  it  is 
seen  in  the  shape  of  small  abscesses  which  are  easily  distinguished  by  the 
naked  eye.  When  a  section  is  made  through  the  kidney,  these  abscesses 
extending  along  the  canaliculi  present  a  peculiar  appearance  and  are 
grayish-yellow  in  color,  round  or  oblong  in  shape,  and  are  generally  sur- 
rounded by  a  red  circle.  When  the  spot  is  examined  under  the  micro- 
scope there  are  swarms  of  micrococci  in  the  centre  of  the  mass,  and  it  is 
reasonable  to  believe  that  these  are  the  causes  of  the  abscesses.  Only  in 
rare  cases  do  the  abscesses  become  confluent,  and  when  they  do  they  form 
large  pus  centres  that,  as  a  rule,  cause  death.  When  the  abscess  forms  in 
the  pelvis  of  the  kidney  the  pus  extends  into  the  straight  urinary  canals, 
in  some  cases  as  far  as  the  surface  of  the  kidney,  and  is  indicated  by  a  pro- 
trusion or  elevation  of  the  external  surface,  which  is  yellowish  in  the  cen- 
tre and  surrounded  by  a  circle  of  yellowish  points.  When  large  abscesses 
are  formed  from  these  and  become  confluent,  the  whole  kidney  may 
become  altered  into  one  large  abscess.  The  covering  capsule  of  the  kidney 
then  becomes  thickened  and  holds  the  abscess  with  its  contents  (pyo- 


188      DISEASES  OF  THE  URINARY  AND  SEXUAL  APPARATUS 

nephrosis).  In  the  early  stages,  -where  the  micrococci  have  just  collected 
in  the  urinary  canals  and  have  started  to  form  abscess  centres,  a  very 
interesting  study  is  afforded. 

Clinical  Symptoms. — The  symptoms  of  abscess  of  the  kidneys  may  not 
differ  to  any  great  extent  from  chronic  nephritis,  the  diagnosis  being 
based  on  local  manifestations,  by  means  of  palpation  of  the  abdomen  in 
the  region  of  the  affected  kidney;  this  may  be  greatly  enlarged  or  even 
fluctuating  if  the  abscess  has  formed  pus.  An  examination  of  the  urine 
may  show  it  to  contain  numerous  pus  corpuscles,  a  large  quantity  of 
micro-organisms,  and  an  excess  of  albumin  and  pus,  blood  cylinders,  renal 
epithelium  and,  in  rare  cases,  we  may  even  find  portions  of  broken-down 
renal  tissue.  It  is  possible,  however,  to  find  an  acute  case  in  which  none 
of  these  symptoms  are  presented  and  where  the  urine  is  practically  clear; 
this  is  particularly  noticeable  when  the  irritation  is  due  to  an  embolus. 
The  whole  appearance  of  the  animal  presents  all  the  symptoms  of  an  acute 
wasting  disease;  the  fever  is  irregular  or  intermittent  and  there  is  gener- 
ally rapid  emaciation. 

Perinephritic  abscesses  may  become  so  large  that  they  form  a  tumor- 
like body  in  the  lumbar  region,  and  the  pus  can  be  detected  under  the 
skin,  in  some  cases  so  large  that  the  enlargement  fluctuates.  When  such 
is  the  case,  and  we  have  confirmed  our  diagnosis  by  means  of  an  exploring 
needle,  the  sac  should  be  emptied  by  an  aspirator  or  by  making  a  fairly 
large  opening  and  emptying  the  abscess  of  its  contents.  It  should  then  be 
washed  out  daily  with  an  antiseptic  solution.  If  the  kidney  itself  is  not 
directly  affected  by  the  abscess,  we  may  expect  a  quick  recovery  under 
good  antiseptic  conditions  (see  treatment  of  wounds). 

Treatment. — If  the  disease  is  confined  to  one  kidney,  the  treatment 
should  be  surgical  and  the  abnormal  kidney  removed,  care  being  taken, 
however,  to  be  sure  the  remaining  kidney  is  normal  and  able  to  perform 
the  duties  of  both. 

Inflammation  of  the  Pelvis  of  the  Kidney. 

(Pyelitis.) 

Etiology. — This  is  caused  by  the  irritation  or  extension  of  certain  in- 
flammations from  the  body  of  the  kidney,  from  poisonous  irritants  passed 
from  the  blood  through  the  kidneys,  from  foreign  bodies  that  lie  in  the 
pelvis,  from  nephritic  stones,  or  strongylus  gigas,  and  this  condition  is 
also  seen  in  infectious  diseases  that  are  acute  in  character,  as  well  as  in 
the  extension  of  inflammation  from  neighboring  organs  (nephritis,  cystitis) 
and  from  any  of  the  various  conditions  that  result  in  interference  with  the 
flow   of  urine,   stricture   of   the  ureters,  from  the  presence  of   calculi, 


HYDRONEPHROSIS  189 

tumors,  or  abscesses  of  the  prostate,  paralysis  of  the  bladder,  as  in  spinal 
paralysis,  or  in  hydronephrosis. 

Pyelitis  occurs  in  a  number  of  forms  varying  according  to  the  intensity 
of  the  irritation  and  is  generally  part  of  other  morbid  processes.  This 
disease  is  recognized  by  means  of  the  microscope,  particularly  when  we 
discover  epithelium  of  the  pelvis  of  the  kidney  in  the  urine,  or  by  manual 
examination  of  the  kidneys  through  the  abdominal  wall,  when  enlarge- 
ment of  the  pelvis  ma}'  be  detected  (see  also  parasites  of  the  kidney) ,  or 
there  may  also  be  present  some  symptoms  of  inflammation  of  the  kidney 
or  catarrh  of  the  bladder.  The  treatment  consists  in  the  attempt  to 
remove  the  original  irritant. 

Hydronephrosis;  Dilatation  of  the  Pelvis  of  the  Kidney. 

Etiology  and  Pathological  Anatomy. — Whenever  there  is  a  stenosis  or 
stricture  of  the  urinary  passages  and  consequent  obstruction,  the  urine 
is  dammed  back  and  presses  on  all  the  canals  behind  the  point  of  obstruc- 
tion, and  as  a  consequence  the  canals  are  distended  and  finally  become 
enlarged.  If  the  obstruction  is  in  the  urinary  tube,  the  bladder,  ureters, 
and  the  pelvis  of  the  kidney  become  enlarged;  but  if  one  ureter  only  is 
afTected,  the  corresponding  kidney  becomes  enlarged;  and  where  the  pelvis 
is  much  distended  and  after  the  condition  has  lasted  some  time,  the  body 
of  the  kidney  becomes  absorbed.  The  whole  kidney  becomes  converted 
into  a  pouch-like  mass  of  connective  tissue,  filled  with  liquid.  This  fluid 
at  first  is  urine,  but  soon  becomes  converted  into  mucous  secretion.  In 
one  case  described  by  Siedamgrotsky,  he  observed,  instead  of  a  kidney,  a 
large  bladder  or  cyst,  with  walls  formed  of  connective  tissue,  filled  with  a 
syrupy  brownish  fluid  containing  numerous  cholesterin  crystals.  This 
condition  is  produced  gradually,  for  any  sudden  interference  or  stoppage 
of  the  flow  of  urine  would  produce  ursemia  or  rupture  of  the  urethra  and 
uraemia  and  death  in  a  short  time,  but  in  hydronephrosis  the  condition 
comes  on  slowly  and  may  result  from  periodic  irritation  and  stricture  of 
the  urethra,  from  tumors  of  the  prostate,  the  presence  of  calculi  in  the 
canals,  or  b}^  inflammation  of  the  mucous  membrane  of  the  bladder. 

Clinical  Symptoms  and  Therapeutics. — The  cystic  kidney  in  slight 
cases  is  rarely  recognized;  in  more  acute  cases  it  is  indicated  by  a  fluctuat- 
ing painless  tumor  in  the  region  of  the  kidney;  in  certain  cases  there  is  a  de- 
cided enlargement  in  the  size  of  the  abdomen;  by  puncture  and  use  of  an 
exploring  trocar  we  find  the  fluid  described  by  Siedamgrotszky,  "When 
there  is  double  hydronephrosis  the  urine  is  suppressed  and  symptoms  of 
uraemia  are  shown  very  quickly.  The  disease  can  only  be  treated  success- 
fully when  it  is  caused  by  obstruction  of  the  urethra;  for  instance,  where 
the  obstruction  is  due  to  a  calculus  in  the  urethra  and  it  is  removed  by 
surgical  means. 


190      DISEASES  OF  THE   URINARY  AND  SEXUAL  APPARATUS 

Nephritic  Stones. 

(Nephroliihiasis;  Renal  Calculi.) 

Nephritic  stones  are  formed  in  the  pelvis  of  the  kidney  and  range  from 
the  size  of  a  mustard-seed  to  that  of  a  pea.  (Megnin  found  two  stones 
each  weighing  six  and  seven  grammes  in  the  pelvis  of  a  dog.)  They  are 
irregular,  warty,  or  sharply  irregular,  and  consist  of  phosphate  and  car- 
bonate of  calcium;  in  rare  instances  the  so-called  cystic  calculi  are  found; 
these,  when  first  removed,  are  soft  waxy  bodies  with  a  dull  surface,  com- 
posed of  triple  phosphate  and  uric  acid. 

The  formation  of  these  collections  is  not  thoroughly  understood,  but 
they  are  probably  formed  by  some  foreign  body,  such  as  mucus,  blood, 
fibrin,  epithelium,  urinary  cylinders,  shreds  of  tissue,  or  collections  of 
bacteria;  and  the  salts  are  deposited  on  this  medium  in  successive  layers, 
so  that  finally  a  large  mass  is  formed. 

Nephritic  stones  may  produce  pyelitis,  pyelonephritis,  or  hemorrhage 
from  the  pelvis  of  the  kidney.  If  the  stone  lies  at  the  entrance  of  the 
ureter  or  even  passes  into  that  canal  and  becomes  lodged,  it  will  retard 
the  flow  of  urine  and  even  cause  rupture  of  the  ureter  or  pelvis  of  the  kid- 
ney and  death  from  peritonitis.  Frccjuently  the  calculus  is  forced  along 
the  ureter,  causing  great  agony,  and  finds  its  way  into  the  bladder.  These 
stones  are  not,  as  a  rule,  diagnosed  with  any  degree  of  certainty  during 
life.  Symptoms  of  pyelitis  wnth  the  continual  passage  of  small  stones  from 
the  urethra  are  about  the  only  indications  that  will  guide  the  observer. 

Tumors  of  the  Kidneys. 

These  neoformations  can  be  determined  only  by  a  manual  examina- 
tion of  the  kidney  through  the  abdominal  wall;  they  frequently  cause  an 
enormous  increase  in  the  size  of  the  kidney,  particularly  so  in  carcinoma, 
the  soft  form  of  cancer  being  most  frequently  seen.  In  the  pelvis  of  the 
kidney  and  the  ureters  we  find  irregular  papilla-like  formations  (carcinoma 
papillomata,  papilloma  destruans  (Kitt) ;  these  may  obstruct  the  normal 
flow  of  urine  and  cause  a  distention  and  enlargement  of  the  pelvis  of  the 
kidney  and  the  renal  ducts  and  an  atrophy  of  the  kidney  itself.  The 
only  possible  relief  to  such  a  condition  is  the  surgical  removal  of  the 
kidney. 

Animal  Parasites  of  the  Kidney. 

Of  the  various  parasites  of  the  kidney  the  strongylus  gigas  has  a 
special  interest.     This  parasite  is  not  unlike  the  common  earth-worm  and 


CATARRH  OF  THE  BLADDER  191 

about  the  thickness  of  a  lead  pencil.  It  is  generally  blood-red  in  color,  and 
invariably  found  solitary.  It  is  usually  found  in  the  pelvis  of  the  kidney, 
causing  great  irritation  of  its  mucous  membrane,  the  pelvis  of  the  kidney 
and  even  the  kidney  itself  being  converted  into  an  enormous  cyst  in  the 
middle  of  which  lies  the  parasite,  twisted  in  a  round  spiral  mass. 

During  life  there  are  no  symptoms  which  could  be  called  characteristic 
and  recognized  with  any  ease.  The  animal  may  show  evidences  at  times 
of  great  pain,  quick  respirations,  moving  from  one  place  to  another,  utter- 
ing occasionally  short  cries  of  pain,  scratching  or  digging  with  the 
paws  in  an  aimless  way,  great  depression,  staggering  gait,  the  back  is 
arched  or  bent  laterally;  in  rare  instances  there  are  severe  cramps  of  the 
posterior  extremities.  The  urine  is  generally  turbid  and  contains  pus; 
under  favorable  circumstances  we  may  find  the  eggs  of  the  parasite,  these 
are  brown  in  color,  oval  in  shape,  and  their  external  surface  is  granular  or 
pitted;  they  are  about  70/i  long  and  40/^  wide.  The  presence  of  the  eggs 
of  the  parasite  is  of  course  positive  evidence  of  its  presence.  The  parasite 
may  find  its  way  into  the  bladder,  producing  a  cystitis,  or  into  the  urethra, 
obstruct  that  canal,  or  it  may  be  passed  out  entirely.  As  a  rule  the  para- 
site causes  so  much  irritation  locally  as  to  cause  the  death  of  the  host. 
Lacosta,  however,  had  a  case  where  the  animal  passed  the  parasite  and 
made  a  complete  recovery.  The  treatment  consists  in  the  administration 
of  oil  of  turpentine  in  repeated  small  doses. 

DISEASES  OF  THE  BLADDER. 

Catarrh  of  the  Bladder;  Inflammation  of  the  Bladder. 

{Cystitis.) 

Etiology. — Catarrh  of  the  bladder  is  generally  caused  by  microbes  such 
as  coli  bacilli  and  their  kindred  bacteria,  and  also  Ijy  the  pyogenic  cocci, 
staphylococci,  streptococci,  etc.,  which  find  their  way  into  it,  as  a  result  of 
certain  infectious  diseases  and  are  eliminated  by  the  kidneys  or  by  certain 
chemical  irritants,  such  as  oil  of  turpentine,  cantharides,  carbolic  acid,  or 
creosote,  and  also  calculi.  Septic  instruments,  such  as  catheters,  Avhen 
introduced  into  the  bladder,  may  set  up  an  irritation  of  the  mucous  mem- 
l>rane.  Cystitis  is  caused  by  the  extension  of  an  irritation  from  the 
urinary  ducts.  In  septic  or  mycotic  inflammations  of  the  intestines,  and 
thus  the  kidney  carrrying  off  waste  materials,  from  irritation  of  the 
pelvis  of  the  kidney,  from  the  uterus,  and  from  retention  of  the  urine, 
caused  by  stones  in  the  urethra  in  bitches.  From  hypertrophy  of  the 
prostate,  or  in  case  of  well  "house-broken"  dogs  that  retain  the  urine, 
being  unable  to  get  oustide,  and  as  a  consequence  of  retention  produce 


192       DISEASES  OF  THE   URINARY  AND  SEXUAL  APPARATUS 

a  paralysis  of  the  bladder,  in  bitches  having  a  difficult  or  protracted 
delivery,  from  traumatisms,  such  as  penetrating  wounds,  or  contusions  as 
a  result  of  being  run  over  by  a  wagon  or  automobile.  Where  the  urine 
becomes  very  alkaline  from  the  excess  of  ammonia,  it  produces  an  irritating 
effect  on  the  bladder,  as  also  does  continual  retention  of  urine,  especially 
when  it  is  heavily  charged  with  salts.  It  has  been  said  that  cold  will 
produce  cystitis.  Cystitis  may  also  be  produced  by  the  extension  of 
inflammation  from  neighboring  regions,  or  in  grave  infectious  diseases 
an  irritation  can  be  caused  by  the  toxins  of  broken-down  micrococci 
being  carried  away 

Pathological  Anatomy. — There  are  quite  a  number  of  varieties  of  cys- 
titis— mucous,  muscular,  serous,  croupal,  ulcerous,  diphtheritic,  and  gan- 
grenous— but,  as  a  rule,  it  is  very  seldom  that  we  can  differentiate  between 
the  various  forms,  and  it  is  best  from  a  practical  standpoint  to  distinguish 
the  disease  as  acute  and  chronic  catarrh  of  the  bladder.  In  the  acute 
form  the  mucous  membrane  of  the  bladder  is  colored  in  an  irregular  way 
by  dark  red  spots.  It  is  also  more  or  less  swollen  and  covered  with  mucus 
and  detached  epithelium.  In  the  later  stages  of  the  disease,  the  mucous 
membrane  may  be  covered  with  detached  epithelium  and  covered  with 
small  hemorrhagic  spots.  In  very  severe  cases  we  find  a  croupous  mem- 
brane covering  the  bladder,  and  it  may  be  so  acute  as  to  cause  gangrene, 
and  mucous  membrane  is  sloughed  off  and  extensive  abscesses  are  formed. 
In  such  cases  the  muscular  and  serous  coats  of  the  bladder  are  also 
greatly  inflamed;  and  if  the  irritation  is  extensive  enough,  we  may  also 
find  evidences  of  peritonitis. 

In  the  chronic  form  the  mucous  membrane  becomes  very  much  thick- 
ened and  covered  with  enlarged  mucous  glands.  The  surface  presents  a 
peculiar  greenish  or  slate-gray  color.  This  is  due  to  the  hemorrhages  that 
occur  in  the  tissues  from  time  to  time.  On  the  surface  we  often  find 
raised  papilla-like  formations,  and  the  submucous  tissues  and  muscles 
are  hypertrophied. 

Clinical  Symptoms  and  Course. — The  first  symptom  noticed  in  this 
disease  is  the  passage  of  an  increased  amount  of  urine,  the  animal  empty- 
ing the  bladder  frequently,  but  passing  only  a  small  quantity  of  urine  each 
time,  at  the  same  time  showing  evidences  of  pain.  In  rare  cases  there 
may  be  a  retention  of  urine  due  to  cramp  of  the  neck  of  the  bladder  from 
irritation.  On  making  an  examniation  of  the  bladder  through  the  abdom- 
inal wall,  the  animal  shows  pain  on  pressure  of  that  region.  An  examina- 
tion of  the  urine  by  the  microscope  will  assist  us  in  making  a  positive 
diagnosis.  If  there  should  be  some  disease  of  the  kidneys  present,  while 
the  specific  gravity  of  the  urine  is  not  much  changed,  in  the  early  stages  of 
the  disease,  it  is  somewhat  darker  than  usual,  and  there  is  an  increase  in 
salts  and  it  contains  only  a  normal  amount  of  mucus,  albumin,  a  few  pus 


CATARRH  OF  THE  BLADDER      '  193 

and  perhaps  a  few  blood  corpuscles,  and  masses  of  bacteria  and  epi- 
thelium of  the  bladder.  This  condition  may  continue  for  a  long  time. 
The  reaction  of  the  urine  depends  on  the  nature  of  the  bacteria  present, 
and  it  is  generally  alkaline  but  may  be  acid,  as  in  cystitis  produced  by  the 
coli  bacilli.  Mild  cases  of  cystitis  are  not  diagnosed,  but  as  the  disease 
continues  the  urine  becomes  thicker  and  turbid,  and  on  making  a  micro- 
scopical examination  of  the  urine  we  find  numerous  pus  cells  and  epi- 
thelium of  the  bladder;  the  urine  rapidly  loses  its  acid  reaction  and  soon 
becomes  neutral  or  alkaline,  and  has  a  strong  ammoniacal  odor.  Urine 
from  an  animal  in  this  condition  ferments  very  rapidly  and  contains  num- 
erous crystals  of  triple  phosphate,  ammoniacal  phosphate  of  magnesia, 
and,  in  rare  instances,  uric  acid  crystals  and  numerous  bacteria. 
(Fig.  81.) 

Fever  as  a  rule  is  present  in  this  disease,  but  is  never  intense,  but  is  of 
rather  an  intermittent  character.  There  is  also  severe  depression  and 
loss  of  appetite.     The  course  of  the  disease,  generally,  is  rapid,  and  in 


Fig.  81. — Urine  of  a  dog  with  cystitis,  triple  phosphate  crystals,  red  and  white  blood  corpuscles,  and 

cystic  epithelium.      Bacteria. 

slight  cases  the  animal  recovers  in  a  few  days;  but  in  acute  cases,  the  acute 
symptoms  may  last  for  weeks,  and  then  the  animal  is  liable  to  have  relapses 
from  time  to  time,  and  if  the  primary  causes  such  as  stone,  urethral 
stricture,  paralysis  of  the  bladder  continue,  the  cystitis  becomes  chronic. 
The  chief  danger  in  cystitis  lies  in  the  possibility  of  a  complication  of  pye- 
litis, pyelonephritis,  suppuration,  paracystitis,  etc.,  and  death  may  finally 
be  caused  by  perforation  of  the  necrosed  bladder  and  the  animal  dies  of  per- 
itonitis, gangrene,  or  uraemia.  The  most  frequent  termination  of  the 
acute  form  is  into  the  mild  chronic  form. 

In  the  chronic  form  the  symptoms  are  much  milder,  and  for  a  long  time 
the  urine  is  the  only  guide  to  a  diagnosis,  as  it  is  only  in  advanced  cases 
that  the  animal  will  show  any  pain  on  pressure  of  the  abdomen;  the  change 
in  the  urine  characteristic  in  this  condition  is  that  it  becomes  strongly 
ammoniacal.  The  contractile  power  of  the  bladder  is  gradually  lost,  and 
the  animal  may  present  symptoms  of  incontinence  of  urine,  passing  small 
quantities  of  urine  without  any  effort;  or  this  is  seen  in  well-trained  house 
13 


194      DISEASES  OF  THE  URINARY  AND  SEXUAL  APPARATUS 

animals  that  pass  small  quantities  of  urine  although  making  every  effort 
to  retain  it  until  they  are  outside;  or  it  may  pass  away  drop  by  drop  when 
they  are  moving  about  or  asleep. 

Therapeutics. — The  treatment  of  cystitis  may  be  dietetic,  medicinal, 
or  local,  according  to  the  symptoms  presented.  In  slight  cases  it  is  only 
necessary  to  administer  non-irritating  agents,  such  as  tartaric  acid,  dilute 
muriatic  acid,  liquor  potassii  acetatis,  or  infusions  of  juniper;  and  a  liquid 
diet,  such  as  milk  or  soups.  This  assists  in  increasing  the  amount  of 
urine  and  also  in  lessening  its  specific  gravity,  and  by  that  means  cleans 
out  the  bladder.     In  the  more  acute  conditions,  we  try  to  correct  the  con- 


FlG.  82. — Apparatus  and  method  of  irrigating  the  bladder  in  the  dog. 

dition  of  the  urine  by  means  of  disinfectants,  such  as  salicylic  acid,  salol, 
boric  acid,  naphthalin,  chloride  of  potassium,  or  urotropin  several  times 
daily  in  0.5  doses,  helmitol  1.0  three  times  daily,  hetralin  2.0  three  times 
daily,  or  a  decoction  of  fol.  uva  ursi.  The  writer  has  always  obtained 
good  results  from  the  administration  of  the  last  two  agents. 

In  the  treatment  of  this  chronic  form,  besides  the  various  alkaline 
salts,  we  should  use  the  resinous  diuretics,  such  as  oil  of  turpentine, 
balsam  of  copaiba,  or  oil  of  sandalwood. 

The  local  treatment  of  the  bladder  is  very  effectual.  This  is  done 
when  the  urine  is  found  to  contain  large  quantities  of  bacteria  and  pus 
corpuscles,  and  when  ammoniaeal  decomposition  appears  very  quickly. 


DEBILITATED  CONDITIONS  OF  THE  BLADDER  195 

This  consists  in  introducing  the  medicinal  agents  directl}''  into  the  bladder 
by  means  of  the  catheter.  The  catheter  is  introduced  into  the  bladder  and 
the  bladder  emptied,  and  by  means  of  a  small  hose  the  catheter  is  con- 
nected with  a  small  funnel  (see  Fig.  82) ,  and  a  medicinal  douche  allowed  to 
flow  into  the  bladder,  and  then  the  hose  is  placed  in  a  dependent  position  and 
the  liquid  allowed  to  trickle  out.  This  can  be  repeated  several  times  with- 
out removing  the  catheter.  When  the  animal  is  very  small  and  a  very 
fine  catheter  is  used,  the  fluid  may  not  flow  freely;  in  such  a  case  a  syringe 
is  adjusted  to  the  end  of  the  catheter  and  the  fluid  forced  into  the  bladder 
and  again  drawn  out  by  means  of  the  syringe,  or  an  aspirator  bottle 
may  be  used. 

The  writer  first  cleans  out  the  bladder  with  clean  water,  then  washes 
with  a  solvition  of  boric  acid,  2  per  cent.,  or  of  tannin  2  per  cent.;  sulphate 
of  zinc  1  per  cent.,  resorcin  1  per  cent.,  nitrate  of  silver  1  to  2  percent. 
Ginsiner  recommends  hydrargyrum  oxycyanatum  1  to  100.  Jahn  had  very 
good  results  with  adrenalin  (suprarenin  in  1  to  10,000)  in  hemorrhagic 
cystitis.  Pressnitz  compresses  or  warm  poultices  to  the  hypogastric  region, 
and  morphine  or  bromide  of  soda  in  cases  where  there  is  involuntary  or 
constant  urination,  also  warm  clysters  to  keep  the  intestines  clear. 
"Where  there  is  extensive  hemorrhage,  give  an  injection  of  2  per  cent,  solu- 
tion of  tannic  acid.  Creolin,  1  per  cent.,  is  also  used,  but  is  not  as  satis- 
factory as  the  former.  The  liquids  must  be  tepid.  In  the  dog,  of  course, 
this  treatment  is  a  little  harder  to  perform  than  in  the  bitch,  but  with  a 
little  practice  it  is  very  easily  accomplished  and  produces  very  satisfac- 
tory results.  With  the  bitch  a  short  metallic  catheter  can  be  used.  It 
must  l^e  remembered  that  house  dogs  must  be  allowed  to  go  out  fre- 
quently as  the  retention  of  urine  is  a  frequent  cause  of  this  condition. 

Debilitated  or  Paralytic  Conditions  of  the  Bladder. 
Paralysis  and  Paresis.     Vesical  Uremia. 

Etiology,  Clinical  Symptoms,  and  Prognosis. — Weak  bladders,  due  to 
paralysis  or  paresis,  are  generally  seen  in  old  dogs,  and  are  produced  by  a 
number  of  causes.  One  frequent  cause  of  this  condition  is  that  house  dogs 
that  cannot  get  outside  or  are  carried  long  distance  on  the  trains,  or  are 
benched  at  a  show,  retain  the  urine  for  a  long  time,  producing  extreme 
distention  of  the  bladder.  Obstructions  of  various  kinds  which  prevent 
the  passage  of  the  urine,  such  as  the  presence  of  a  calculus  at  the  neck  of  the 
bladder  or  in  the  urethra,  as  hypertrophy  of  the  prostate,  strictures  of  the 
urethra,  by  weakness  of  the  muscular  coat  of  the  bladder,  caused  by 
chronic  catarrh  of  that  organ,  and  certain  diseases  of  the  nervous  system 
al.<o  produce  this  condition. 


196      DISEASES  OF  THE  URIXARY  AXD  SEXUAL  APPARATUS 

This  condition  ma}'  also  bo  the  result  of  fracture  of  the  vertebrae, 
extensive  hemorrhage  of  the  spine,  myelitis,  spinal  meningitis,  tumors, 
poison  and  general  debility. 

Clinical  Symptoms. — There  are  two  forms  of  this  disease :  Paralysis  of 
the  detrusor  and  paralysis  of  the  sphincter  vesicae.  It  is  c^uite  common 
to  find  both  conditions  present  in  one  animal.  In  the  first  condition 
(ischuria,  retentio  urinae)  the  bladder  becomes  so  distended  that  its  elas- 
ticity is  lost,  and  the  muscular  coat  loses  its  power  of  contraction,  and,  fin- 
ally, when  the  bladder  is  so  distended  that  the  connective  tissue  alone 
holds  it  and  presses  on  the  sphincter  vesicae  and  overcomes  it,  the  urine 
trickles  out  in  small  quantities,  the  animal  is  uneasy,  makes  frecjuent  at- 
temps  to  urinate  and  may  or  may  not  succeed  in  passing  any  urine;  on  pal- 
pation of  the  abdomen  the  bladder  is  found  greatly  distended,  and  mere 
manual  pressure  on  the  alxlominal  walls  in  the  region  of  the  distended 
bladder  may  cause  evacuation  of  that  organ;  the  urine  passed  is  foiuid  to  be 
highly  concentrated  and  has  a  very  unpleasant  odor.  The  paralysis  of  the 
spincter  vesicae  is  termed  overflowing  of  the  bladder  (urination  Ijy  incon- 
tinence). When  the  sphincter  is  paralyzed  the  urine  flows  constantly  or 
at  very  short  intervals,  the  slightest  contraction  of  the  depressor  being 
sufficient  to  expel  it;  this  is  painless  to  the  animal.  In  this  condition  the 
bladder  is  nearly  always  empty.  In  making  an  examination  of  the  blad- 
der through  the  abdomen,  when  paralysis  of  the  detrusor  is  present,  the 
bladder  will  be  found  distended,  even  when  the  animal  has  passed  some 
urine  only  a  short  time  before,  whereas  in  paralysis  of  the  spincter  the 
bladder  will  be  found  to  be  empty.  As  a  rule  there  is  no  great  change  in 
the  animal's  condition,  except  in  these  cases  where  the  original  cause  is 
some  disorder  of  the  spine;  then  the  appetite  is  scanty  and  the  animal 
shows  great  disinclination  to  exercise. 

When  cystitis  accompanies  this  condition  the  animal  shows  more  or 
less  pain  when  it  urinates.  This,  however,  is  seen  only  in  rare  instances. 
In  the  majority  of  cases  the  prognosis  is  unfavoral)le;  the  only  cases  in 
which  a  favorable  termination  is  to  l)e  expected  are  those  of  simple  dis- 
tention of  the  ])ladder,  as  in  house  dogs,  when  from  overdistention  of  the 
bladder  when  the  animal  cannot  get  out,  or  when  a  calculus  is  in  the  blad- 
der or  urethra  and  the  cause  is  removed  surgically. 

Therapeutics. — The  treatment  best  adapted  to  relieve  this  condition  is 
to  regulate  the  passage  of  urine,  as  in  catarrh  of  the  ])ladder,  by  pressing 
the  bladder  through  the  al)dominal  wall  and  emptying  it,  or  catheteriza- 
tion and  by  injections  into  the  bladder  of  claret  wine,  solutions  of  tannin 
1  to  2  per  cent,  internally,  or  tine,  nux  vomicae  5  to  10  drops  once  or  twice 
daily,  strychnia  muriate  0.001  to  0.003  subcutaneously,  or  fluid  ext. 
ergotae  0.50.  We  can  also  try  faradization  of  the  vertel)rae  over  the  lumbar 
region  or  massage  of  the  abelomen  in  the  region  of  the  bladder. 


STOXE  IN  THE  BLADDER  197 

Stone  in  the  Bladdeio 

(Lithiasis.) 

Etiology  and  Pathological  Anatomy. — The  various  lithic  formations 
found  to  originate  in  the  pelvis  of  the  kidney  and  the  bladder  are  found 
either  in  the  form  of  fine  sand-like  or  gritty  substances,  or  formed  calculus; 
these  may  be  s\i1)divided  into  urates,  oxalates,  phosphates,  and  cystates. 

Urates. — These  consist  of  uric  acid  or  uric  acid  salts,  or  both  in  com- 
bination. They  are  small,  hard,  yellowish  or  reddish-brown  bodies,  hav- 
ing a  smooth  surface;  on  cutting  through  the  centre  they  are  found  to  be 
formed  in  concentric  layers  or  strata. 

Oxalates  are  composed  chiefly  of  oxalic  acid  and  lime  salts,  and  are 
more  or  less  mixed  with  uric  and  phosphoric  acids.  They  are  hard, 
brown  in  color,  and  have  an  irregular  mulberry-like  surface. 

Phosphates. — These  are  composed  of  phosphoric  acid,  lime,  and  triple 
phosphates.  They  are  gray-white  in  color  and,  as  a  rule,  are  soft  and 
friable. 

Cystic  Stones. — These  are  soft,  wax-like  bodies,  having  a  shiny 
crystalline,  irregular  surface. 

All  these  lithic  deposits  contain  besides  their  inorganic  elements, 
numerous  organic  elements,  such  as  epithelium,  blood  cells,  mucus,  etc. 

Klemmer  found  on  careful  examination  of  3301  dogs  that  12  or  about 
0.38  per  cent,  were  affected  with  stone.  The  size  to  which  these  calculi 
may  grow  is  considerable.  In  Dresden  there  is  a  calculus  taken  from  a 
German  boar-hound  that  is  11  cm.  long  and  7.5  cm.  wide,  6  cm.  thick, 
which  weighed  490  grammes  Avhen  fresh.  They  are  generally  started  in 
their  formation  in  the  pelvis  of  the  kidney,  and,  generally,  from  some  for- 
eign body,  such  as  a  blood  clot,  a  piece  of  mucus,  epithelium,  etc.,  around 
which  the  sediment  in  the  urine  forms  and  gradually  the  crystalline  ele- 
ments accumulate.  This  deposit  is  formed  very  quickly  in  cases  of 
cystitis,  Avhere  the  urine  is  undergoing  alkaline  fermentation  and  pro- 
duces a  copious  sediment  in  the  urine. 

Paul  Bert  and  Studensky  found  by  experiments  that  the  food  and  fluids 
that  the  animal  takes  may  have  a  certain  influence  on  the  formation  of 
stone  in  the  bladder.  The  former  mentions  two  cases  in  which  one  was 
fed  exclusively  on  meat  and  the  other  on  vegetables.  On  post-mortem  of 
the  animal  fed  on  meat  there  was  found  a  phosphatic  calculus,  but  no 
trace  of  inflammation  of  the  urinary  organs. 

Studensky  placed  foreign  bodies  in  the  bladder  and  found  that  when 
the  animal  was  allowed  to  drink  only  water  that  was  thoroughly  impreg- 
nated with  lime  salts  that  there  was  soon  formed  over  the  body  a  thick, 


198       DISEASES  OF  THE   URINARY  AND  SEXUAL  APPARATUS 

heavy  deposit  of  lime  salts,  and  that  results  differed  greatly  in  animals 
fed  in  the  usual  way,  with  pure  water  and  meat.  In  the  latter  case  the 
concretion  was  much  smaller  and  deposited  much  more  slowly. 

The  irritation  produced  l^y  stone  in  the  pelvis  of  the  kidney  has 
l^een  already  pointed  out  (see  page  190.)  Stones  in  the  bladder,  as  will  be 
spoken  of  later,  cause  not  only  interference  with  the  flow  of  urine,  but 
by  their  weight  and  position  may  cause  a  hypertrophy  of  the  walls 
of  the  l)ladd(>r. 

Clinical  Symptoms  and  Course. — When  the  uric  calculus  lies  in  the 
bladder  and  has  not  attained  any  size,  it  may  stay  there  a  long  time  and 
not  produce  any  marked  symptoms,  with  the  exception  of  a  slight 
catarrh,  and  that  is  only  noticed  when  the  animal  has  had  a  long  run, 
the  urine  then  being  voided  with  great  difficulty,  perhaps  mixed  with 
blood  or  mucus,  and  has  a  penetrating  odor.  Palpation  through  the 
alxlominal  wall,  even  when  the  liladder  is  partially  filled,  may  discover 
the  stone  as  a  hard  l)ody  lying  in  the  bladder;  in  the  Ijitch,  the  urethra 
l)eing  very  short,  it  is  easily  detected  by  means  of  a  catheter.  When  the 
stone  gets  into  the  neck  of  the  bladder  or  passes  into  the  urethra  and 
lodges  at  the  posterior  end  of  the  bone  of  the  penis  very  severe  symptoms 
are  noticed.  Retention  of  urine  is  indicated  by  an  entire  suppression 
(ischuria),  or  urine  is  passed  in  a  thin  stream  or  only  by  a  drop  at  a  time, 
the  animal  showing  great  pain.  A  partial  obstruction  of  urine  is  soon  fol- 
lowed by  a  complete  obstruction. 

The  symptoms  presented  in  the  dog  are  very  striking.  The  animals 
are  very  restless,  looking  frecjuently  towards  the  region  of  the  kidney  and 
whining.  They  place  themselves  in  the  position  to  urinate  and  strain 
violently  without  any  result,  or  perhaps  a  few  drops  are  passed  and  these 
may  be  mixed  with  blood.  The  appetite  is  lost  and  the  pulse  is  rapid  and 
thready;  they  stand  with  an  arched  back  or  walk  with  a  staggering  gait 
and  extended  legs.  The  abdomen  becomes  distended  and  we  can  finally 
feel  the  bladder  through  the  abdominal  walls  like  a  hard,  distended  body 
which  is  very  painful  on  examination.  When  the  catheter  is  passed  it 
goes  in  easily  enough  until  the  neck  of  the  bladder  is  reached,  when  it 
stops  and  cannot  be  passed  any  further,  and  no  urine  escapes  from  the 
catheter. 

Uric  calculi  lie  on  the  floor  of  the  bladder  and  can  be  felt  through 
the  abdominal  walls  liy  manipulation,  that  is,  of  course,  when  they  have 
reached  a  good  size;  the  small  ones  escape  detection,  but  they  may  be 
suspected  when  the  urine  has  a  gravel  or  sand-like  sediment. 

The  urine,  when  it  is  retained  in  the  bladder,  gradually  accumulates, 
and  if  it  is  not  drawn  off  in  three  days  the  bladder  is  ruptured;  it  may  even 
burst  in  two  days.  AVhen  this  occurs  it  causes  death  in  a  few  hours,  with 
tlie  following  symptoms:  the  animal   liecomes  dull   or  comatose,  with 


STONE  IN  THE  BLADDER  199 

shaking  or  trembling  of  the  muscles,  and  the  restlessness  and  pain  seem  to 
have  disappeared.  Pressing  on  the  abdomen  may  produce  great  evidence 
of  pain,  but  in  the  majority  of  cases  this  is  absent.  After  the  first  two 
hours  the  abdominal  wall  is  covered  with  a  cold  sweat,  and  the  bladder 
cannot  be  felt  on  manipulation.  Soon  a  deep  coma  /rom  which  the  ani- 
mal cannot  be  roused  sets  in  and  dies  in  a  short  time.  In  rare  instances 
the  animal  may  have  convulsions,  which  occur  with  short  intervals  be- 
tween them.  Death  may  also  occur  before  the  bladder  is  ruptured,  as  a 
consequence  of  extensive  gangrenous  cystitis  with  pyelitis. 

Therapeutics. — While  the  first  procedure  in  treatment  of  stone  is  essen- 
tially surgical,  however  in  cases  where  the  animal  passes  very  small  cal- 
culi or  sand-like  particles  and  shows  every  evidence  of  the  presence  of 
cystic  calculi  or  where  an  animal  passes  small  stones  which  lotlge  at  the 
end  of  the  penal  bone  and  has  to  be  operated  on  frequently,  he  should  be 
given  large  quantities  of  liquids  or  w^aters  that  are  supposed  to  have 
litholytic  action — for  instance,  acids  for  dissolving  phosphatic  calculi, 
alkalines  for  breaking  up  uric  calculi,  or  lithia  mineral  waters,  such  as 
A'ichy,  Kissingen,  Carlsbad.  Or  the  l:)ladder  may  be  washed  out  with 
various  solutions  (see  cystitis).  In  oxalate  and  cystic  stone  the  animal 
should  be  given  all  the  water  it  will  take.  When  the  stone  is  present  and 
is  causing  retention  of  urine,  there  is  nothing  left  then  but  to  remove  the 
stone  by  means  of  an  operation  called  urethrotomi)  if  the  stone  is  lodged 
in  the  urethra  at  the  posterior  end  of  the  bones  of  the  penis,  or  cystotomif 
if  the  stone  is  located  in  the  bladder;  this  operation  is  performed  by  open- 
ing the  urethra  at  the  ischial  arch,  and  by  means  of  a  small  pair  of  forceps 
introduced  into  the  bladder,  through  the  urethra,  the  stone  is  grasped  and 
crushed  and  afterward  washed  out  of  the  bladder.  In  the  ])itch  an 
incision  is  made  into  the  short  urethra  and  the  stone  is  seized  and 
crushed  in  a  like  manner. 

When  ischuria  or  stoppage  of  urine  is  present,  the  treatment  depends 
to  a  large  extent  on  the  location  of  the  calculus — that  is,  whether  it  is  in  the 
neck  of  the  bladder  or  whether  it  has  gone  into  the  urethra  some  distance 
and  lodged  there.  In  the  first  instance  we  can  sometimes  introduce  the 
catheter  and  by  a  gradual  pressure  we  can  push  the  stone  into  the  bladder; 
or  if  it  is  further  in  the  urethra,  we  can  push  a  well-lubricated  catheter 
past  the  stone  and  allow  the  escape  of  urine  and  prepare  for  the  operation, 
for  if  the  stone  is  in  the  urethra  this  must  be  performed  immediately. 

Urethrotomy. — This  is  usually  performed  from  the  posterior  end  of 
the  bone  of  the  penis,  as  the  great  majority  of  uric  calculi  pass  down  the 
urethra  and  lodge  at  the  posterior  end  of  the  bone  of  the  penis  and  can  l)e 
detected  by  the  catheter;  when  this  is  passed  and  comes  against  the  stone 
there  is  a  certain  rough  sound  felt  that  resembles  crepitation.  Lay  the 
animal  on  tlie  side  or  back,  and  after  having  injected  cocaine  into  the  skin 


200      DISEASES  OF  THE  URINARY  AND  SEXUAL  APPARATUS 

(or  administered  ether  if  the  animal  be  very  hard  to  handle,  although  this 
procedure  is  rarely  necessary)  insert  a  well-oiled  catheter,  make  an  incision 
about  3  cm,  in  length,  cutting  down  on  the  median  line  on  the  skin  making 
a  free  opening,  then  cut  a  second  longitudinal  incision  on  the  urethra  on  the 
stone  or  on  the  end  of  the  catheter  (Fig.  83);  calculus  can  then  be  pushed 
back  toward  the  opening  in  the  majority  of  cases,  and  by  means  of  a  pair 
of  small  forceps  the  stone  is  grasped  and  pulled  out.  In  some  cases  it  is 
necessary  to  enlarge  the  opening  in  the  urethra;  as  a  rule,  however,  do  not 
make  the  opening  any  larger  than  is  absolutely  necessary.  Occasionally 
when  the  stone  lies  in  the  canal  just  under  the  bone  of  the  penis,  it  is  ex- 
tremely hard  to  remove,  and  after  making  the  incision  it  has  to  be  forcibly 


Fig.  S3. — Urethrotomy.     Catheter  introduced  and  end  seen  at  the  incision. 


dislodged  by  means  of  the  catheter.  It  is  well  to  leave  the  wound  open 
unless  it  is  a  very  large  animal  or  the  stone  should  be  exceptionally  large;  in 
that  instance  do  not  put  more  than  one  stitch  in  it.  For  two  days  the 
lu'ine  escapes  out  of  the  external  opening,  but  soon  closes  up,  and  in  about 
eight  to  ten  days  it  has  closed  up  completely  and  the  urine  is  passed  in  the 
natural  way. 

The  wound  of  the  operation  is  apt  to  leave  a  stricture  in  the  course  of 
the  urethra,  and  in  an  animal  that  is  predisposed  to  the  formation  of  calculi 
examine  the  urethra  occasionally  with  the  catheter  and  if  a  stricture  is 
present  dilate  it  with  a  bougie. 

In  cases  where  the  stone  is  situated  up  in  the  urethra  at  the  ischial 
arch  it  is  nuich  more  difficult  to  oj^erate  on  account  of  the  well-developed 


STONE  IN  THE  BLADDER  201 

bulbus  cavernosum.  The  incision  must  be  made  down  on  the  catheter, 
which  has  been  previously  inserted  as  far  up  as  possible.  The  higher  op- 
eration must  never  be  attempted  unless  this  latter  precaution  is  taken,  as 
it  is  almost  impossible  to  find  the  urethra  unless  the  sound  is  in  it. 

Another  mode  of  operation  is  to  introduce  a  catheter  into  the  penis 
until  it  reaches  the  obstruction,  and  by  means  of  a  tape  looped  around 
the  free  end  of  the  penis  it  is  drawn  away  from  the  prepuce,  which  is 
held  back  ])y  an  assistant,  and  then  cut  down  on  the  end  of  the  catheter; 
the  catheter  is  pulled  back  a  short  distance,  but  not  entirely,  and  the 
penis  bent  over,  and  by  means  of  a  small  pair  of  blunt  forceps  the  stone 
can  be  removed;  when  this  is  accomplished  pass  the  catheter  into  the 
bladder  and  wash  out  any  calculi  that  may  still  remain  in  the  bladder 
or  urethra;  by  means  of  a  small  hose  attach  the  catheter  to  a  syringe  and 
inject  the  bladder  full  of  tepid  water. 

In  the  bitch  the  operation  is  much  more  simple.  The  urethra  is 
opened  by  means  of  a  thin  tenotome  introduced  on  a  grooved  director 
and  the  opening  enlarged,  and  then  the  forceps  passed  into  the  opening, 
the  stone  crushed,  and  the  bladder  washed  out.  It  is  generally  necessary 
to  introduce  one  finger  into  the  rectum  to  guide  the  stone  into  the  forceps 
before  it  can  be  grasped.  Great  care  must  be  taken  in  such  an  operation 
to  avoid  crushing  the  tissues.  In  the  bitch  there  is  no  after-treatment 
necessary. 

Cystotomy. — Laprocystotomy,  or  cutting  through  the  abdominal 
wall  is  the  only  mode  permissible  on  the  dog,  lithotripsy  being  pro- 
hibited on  account  of  the  size  and  anatomy  of  the  urethra  of  the  dog. 

Laprocystotomy,  cystotomy  suprapubica:  Preparatory  to  the  op- 
eration the  urine  is  removed  from  the  bladder  and  the  bladder  washed 
out  with  a  2  per  cent,  solution  of  boracic  acid,  the  tissues  in  the  neighbor- 
hood of  the  incision  thoroughly  cleansed  and  disinfected,  the  animal  is 
put  under  ether  and  an  incision  is  made  in  front  of  the  pul^is  parallel 
with  the  prepuce  and  directly  on  the  median  line  (in  the  bitch  cut 
directly  on  the  linea  alba);  make  an  incision  about  5  to  8  cm.  long, 
take  up  the  hemorrhage  by  means  of  absorl)ent  cotton,  then  draw 
out  the  bladder,  surround  it  with  cotton  compresses  and  an  incision 
about  1  to  3  cm,  is  made  in  the  bladder  and  by  means  of  a  pair  of 
forceps  the  stone  removed,  if  the  stone  is  incysted  it  should  be  scraped 
out;  the  bladder  is  then  washed  out  with  boracic  acid  solution,  the 
wound  stitched  with  carbolized  catgut,  the  muscular  and  serous  coats 
are  sewed  with  the  edges  turned  inward,  the  stitches  must  be  put  very 
close  together  as  distention  with  urine  causes  the  very  elastic  bladder  to 
open  and  allow  the  escape  of  urine  into  the  peritoneal  cavity;  return  the 
bladder  after  having  first  cleansed  it  with  boracic  acid  solution,  and 
the  abdominal  wall  closed  and  the  wound  covered  bv  a  bandage.     As 


202      DISEASES  OF  THE  URINARY  AND  SENUAL  APPARATUS 

l:)lood  clots  are  apt  to  form  in  the  course  of  the  urethra,  French  advises 
that  the  animal  be  catheterized  at  least  twice  daily  until  normal  urina- 
ation  is  established. 

When  the  bladder  is  so  distended  that  it  is  deemed  dangerous  to 
operate  before  emptying  the  bladder  of  its  contents,  we  may  empty  the 
bladder  by  means  of  a  fine  trocar  and  canula.  In  the  bitch  the  trocar 
should  be  introduced  on  the  median  line,  at  the  brim  of  the  pelvis,  and 
in  the  dog,  either  on  the  right  or  left  side  of  the  flank,  low  down  and  as 
near  as  possible  to  the  brim  of  the  pelvis. 

Sometimes  ruptures  of  the  bladder  are  caused  bj^  accidents,  such  as 
being  run  over  by  wagons  when  the  l;)ladder  is  full.  The  animal  dies, 
as  a  rule,  in  forty-eight  hours,  from  collapse,  before  peritonitis  has  devel- 
oped. On  post-mortem,  the  !)ladder  is  found  to  be  infiltrated  with 
blood  and  very  much  swollen  at  the  lacerated  i-egion  only.  In  injuries 
to  the  lumbar  region,  where  the  animal  is  dull  or  even  comatose,  it  is 
always  well  to  consider  the  prognosis  doubtful,  and  Siedamgrotzky 
deems  it  advisable  to  consider  the  prognosis  doubtful  in  injuries  to  that 
region,  even  w^here  there  are  no  acute  symptoms  presented. 

Stricture  of  the  Urethra. — Indications  of  painful  retention  of  urine 
are  often  presented  when  there  is  a  stricture  of  the  urethra  caused  liy 
injuries  to  the  urethra  from  calculi  or  by  cicatricial  contraction  following 
the  operator's  knife,  from  intense  nephritis,  or  by  torsion  following  co- 
itus. An  examination  by  means  of  the  catheter  generally  gives  some 
information  as  to  the  character  of  the  stricture;  the  practitioner  must, 
however,  rememl^er  that  there  is  always  more  or  less  normal  stricture 
at  the  posterior  end  of  the  bone  of  the  penis.  The  sound  must  be  passed 
each  day  and  allowed  to  remain  about  twenty  minutes  if  the  stricture 
will  admit  of  it.  The  size  of  the  catheters  must  be  gradually  increased; 
great  care  being  taken  to  thoroughly  disinfect  the  catheters  after  each 
insertion.  This  method  has  been  used  with  success  in  a  number  of  cases 
of  stricture,  but  it  must  he  continued  for  several  weeks. 

Hoffman  cured  a  case  of  stricture  of  the  posterior  end  of  the  bone 
of  the  penis  l)y  opening  the  urethra  at  the  spot  of  stricture  and  ampu- 
tating al)Out  2  cm.  of  the  bone  of  the  penis  with  a  pair  of  bone  forceps. 

Other  diseases  of  the  bladder. 

The  following  are  comparatively  rare  and  unimportant  diseases  of 
the  l)ladder. 

Cramp  of  the  Bladder,  Cystospasmus. — This  is  seen  following  severe 
cystitis,  calculi,  diseases  of  the  prostate,  etc.  This  condition  is  also  ob- 
served as  a  symptom  from  the  effects  of  certain  poisons,  decayed  food, 
from  disease  of  the  spine  and  from  unknown  causes.     It  is  indicated  by 


OTHER  DISESES  OF  THE  BLADDER  203 

persistant  cramp  of  the  sphincter  antl  retention  of  the  urine  (retentio 
iirinse).  The  treatment  consists  in  friction  in  the  region  of  the  bladder, 
luke-warm  clysters  to  Avhich  chloral  hydrate  may  be  added,  subcutane- 
ous injection  of  morphia  and  the  administration  of  boldine. 

Neoformations  of  the  Bladder. — The  tumors  of  the  bladder  worth 
special  mention  are  papilloma  villosum  and  the  carcinoma  papillomato- 
des.  The  early  symptoms  are  profuse  hemorrhage  which  occurs  from 
time  to  time,  producing  acute  anaemia  and  often  causing  death.  These 
tumors  are  generally  associated  with  chronic  cystitis.  In  the  region  of 
the  bladder  we  are  sometimes  able  to  detect  these  neoformations  in  the 
form  of  a  soft  tumor-like  mass  and  in  rare  instances  we  may  find  some 
portions  of  the  broken-down  tissue  in  the  urine.  In  some  instances  in- 
stead of  a  solitary  tumor  we  may  find  a  diffuse  mass  spreading  over  the 
wall  of  the  bladder  which  on  palpation  feels  like  a  hard  irregular  body. 
Other  pathological  growths  may  be  sarcoma,  carcinoma  or  myoma.  It 
may  be  possible  under  very  favorable  circumstances,  to  remove  these 
tumors  by  means  of  cystotomy,  but  it  is  very  rarely  done,  for  generally 
when  we  make  the  diagnosis  the  tumors  have  reached  considerable  size 
and  involve  the  entire  bladder. 

Retroflection  of  the  Bladder. — This  condition  may  be  found  as  a 
result  of  constipation  or  disease  of  the  prostate,  and  from  constant  strain- 
ing and  tension,  a  distended  bladder  may  be  retroverted  and  lie  be- 
tween the  rectum  and  the  prostate  and  may  cause  the  development 
of  a  perineal  hernia.  If  pressure  is  made  on  the  soft  fluctuating  hernial 
tumor,  the  animals  are  apt  to  place  themselves  in  a  position  to  urinate. 
The  treatment  consists  in  attempting  to  remove  the  original  cause  by 
means  of  laxatives,  warm  baths,  rectal  enemas  (see  Diseases  of  the 
Prostate) .  If  these  methods  do  not  succeed  and  the  distention  of  the  blad- 
der becomes  very  pronounced,  first  try  to  empty  the  bladder  by  means  of 
the  catheter  and  if  that  cannot  be  accomplished,  on  account  of  the  twist 
in  the  urethra,  then  empty  the  bladder  by  means  of  a  trocar;  the  punc- 
ture is  to  be  made  in  the  upper  part  of  the  tumor.  Generally  when  the 
bladder  is  emptied  it  falls  back  into  position,  but  the  condition  may  re- 
turn if  the  exciting  causes  return.  To  obtain  a  permanent  fixture  of 
the  bladder,  we  must  perform  cystopexia  (after  Hendrix).  This  con- 
sists in  making  an  incision  into  the  abdominal  wall  on  one  side  of  the 
penis  as  near  the  median  line  as  possible;  insert  the  finger  into  the  cavity 
and  return  the  bladder  to  its  normal  position  and  suture  it  to  the  ab- 
dominal wall,  so  that  the  centre  of  the  posterior  wall  of  the  bladder  will 
.lie  on  the  anterior  margin  of  the  pubis. 

Inflammation  of  the  Urethra — Urethritis. — This  is  very  rarely  ob- 
served, being  invariably  caused  by  some  traumatism,  calculus  or  other 
foreign   bodies,    improper   catheterization,    injuiies    during   coitus    (see 


204       DISEASES  OF  THE   URIXARY  AXD  SEXUAL  APPARATUS 

gonorrhoea  of  the  prepuce).  The  symptoms  consist  in  the  constant 
flow  of  a  muco-puriilent  fluid  from  the  urethra,  redness  and  tumefaction 
of  the  external  orifice,  the  animal  places  himself  in  a  position  to  urinate 
and  if  he  does  succeed  in  urinating  he  shows  great  pain.  On  making 
any  pressure  on  the  urethra,  a  few  drops  of  a  muco-purulent  discharge 
comes  from  the  external  opening.  The  treatment  consists  in  the  in- 
jections of  astringents,  claret  wine,  sulj^hate  of  zinc,  and  1  to  2  per 
cent,  solutions  of  nitrate  of  silver. 


DISEASES  OF  THE  MALE  SEXUAL  ORGANS. 

DISEASES  OF  THE  PROSTATE. 
INFLAMMATION  OF  THE  PROSTATE. 

{Prostatitis.) 

A  number  of  causes  lead  to  inflammatory  processes  in  the  prostate 
which  produce  hypertrophy  or  neoformations  of  that  organ;  the  enlarge- 
ment may  be  temporary  or  permanent,  but  as  a  rule  it  invariably  pro- 
duces more  or  less  interference  with  the  evacuation  of  the  faeces,  and  ob- 
struction of  the  free  passage  of  urine. 

Inflammation  of  the  Prostate. — This  may  result  as  a  complication 
of  cystitis,  urethritis,  urinary  calculi,  from  careless  or  ignorant  catheter- 
ization and  from  the  pressure  of  hard  masses  of  faeces  lying  in  the  rectum 
in  persistent  constipation,  proctitis,  etc.  Prostitis  is  also  observed  in 
stud  dogs  that  have  served  a  large  number  of  bitches  within  a  compara- 
tively short  space  of  time  or  have  been  in  the  stud  for  a  number  of  years, 
and  it  also  results  from  pyaemia. 

Symptoms  and  Course. — The  disease  may  occur  in  the  acute  or 
chronic  form;  the  latter  is  discussed  under  hypertrophy  of  the  prostate. 

The  acute  form  is  rare  and  causes  the  animal  to  walk  with  back 
arched  and  a  stiff,  stilted  gait,  and  show  evidence  of  great  pain  when 
either  urine  or  faeces  are  passed.  In  cases  where  there  is  great  enlarge- 
ment of  the  prostate  the  animal  may  hold  the  faeces  and  cause  constipa- 
tion by  not  putting  any  pressure  on  the  abdominal  muscles  or  may  also 
retain  the  urine.  On  making  an  examination  of  the  gland,  by  introduc- 
ing the  finger,  well  luliricated,  into  the  rectum,  we  find  it  very  much  en- 
larged, hot  and  painful  to  the  touch,  and  the  animal  shows  great  de- 
pression, loss  of  appetite  and  fever.  The  animal  exhibits  great  pain 
during  catheterization  when  the  instrument  passes  the  prostate. 

The  terminations  of  this  acute  condition  are  as  follows: 

The  prostate  may  break  down  and  suppurate,  forming  a  fluctuating 


INFLAMMATION  OF  THE  PROSTATE  205 

tumor  in  the  pelvic  cavity;  accompanied  by  great  difficulty  in  urination, 
or  it  may  assume  the  chronic  form  and  develop  cysts;  this  latter  condi- 
tion, however,  is  rarely  diagnosed  during  life.  Sometimes  these  cysts 
are  seen  on  post-mortem,  ami  the  animal  previous  to  that  was  with- 
out any  fever  or  acute  symptoms,  or  the  inflamed  prostate  may  ulti- 
mately form  abscesses  which  break  through  into  the  urethra,  or  the 
rectum,  and  in  very  rare  cases  into  the  connective  tissue  of  the  pelvis. 
In  the  latter  termination  we  find  a  gradual  tumefaction  and  formation 
of  an  abscess  in  the  perineal  region,  which  suppurates  and  breaks, 
or  there  may  be  the  formation  of  small  abscesses  which  become  encapsu- 
lated in  the  prostate. 

Therapeutics. — This  consists  in  giving  the  animal  small  quantities 
of  non-irritating  food,  cold  clysters  and  cold  or  luke-warm  applications 
to  the  perineum;  also  the  frequent  passage  of  the  catheter  to  prevent 
overretention  of  urine  in  the  bladder;  and  also  the  administration  of 
saline  purgatives,  such  as  sulphate  of  magnesium,  Carlsbad  salt,  etc. 
When  pus  has  formed,  which  can  be  determined  by  digital  examina- 
tion per  rectum,  introduce  a  speculum  into  the  rectum  and  cut  down  on 
the  fluctuation  by  means  of  a  sharp-pointed  bistoury.  The  hemorrhage 
which  follows  is  very  slight,  and  no  attention  should  be  paid  to  it.  Hen- 
drix  introduces  the  finger  into  the  rectum  and  puts  considerable  pressure 
on  the  fluctuating  prostate  and  breaks  the  abscess  into  the  urethra. 
Where  the  swelling  extends  to  the  perineum  and  distends  it,  it  is  best  to 
apply  warm  applications  until  the  pus  has  formed,  and  then  cut  down 
and  evacuate  the  sac. 

Chronic  Prostitis  (Hypertrophy)  of  the  Prostate. — This  is  the  form 
of  the  disease  most  frequently  seen,  and  develops  from  the  acute  form, 
but  in  the  majority  of  cases  the  disease  starts  in  at  the  onset,  as  the  chronic 
form.  It  is  a  common  disease  in  old  dogs,  and  is  indicated  by  a  hyper- 
trophy of  the  whole  organ;  as  a  rule,  the  swelling  is  symmetrical,  but 
sometimes  one  side  of  the  gland  is  larger  than  the  other.  It  varies  in 
consistency;  in  some  cases  very  hard,  in  others,  soft;  in  the  former  case 
it  is  due  to  a  hyperplasia  of  the  fibro-muscular  tissue;  in  the  latter  it 
is  due  to  an  infiltration  of  the  gland  with  a  purulent  fluid  as  a  consequence 
of  chronic  purulent  inflammation. 

The  symptoms  of  a  hypertrophy  of  the  prostate  are  irregular;  in 
some  cases  there  is  difficulty  in  urination  (dysuria,  strangury),  and  also 
more  or  less  cystitis  and  pyelitis,  etc.,  or  constipation  due  to  the  animal 
making  no  effort  to  evacuate  faeces.  The  surest  means  of  diagnosis  is  to 
make  a  digital  examination  of  the  prostate  per  rectum.  It  is  dis- 
tinguished from  the  acute  form  by  the  absence  of  heat  and  sensitiveness, 
but  is  very  much  larger  than  the  normal  gland.  Rossi  contends  that 
hypertrophy  of  the  prostate  does  not  affect  the  urinary  canal  to  any  great 


206      DISEASES  OF  THE  URIXARY  AND  SEXUAL  APPARATUS 

extent;  the  tissues  of  the  prostate  only  are  affected  and  situated  as  it  is 
on  the  floor  of  the  pelvis,  it  has  plenty  of  room  to  expand.  Lienaux 
observed  one  case  where  there  were  intermittent  hemorrhages,  and  finally 
interference  in  urination  and  evacuation. 

Therapeutics  are  not  productive  of  much  good  results.  For  the 
constipation  give  saline  laxatives;  if  the  urine  is  retained,  catheterize 
the  bladder  and  administer  internally  ergot  or  iodide  of  potassium.  The 
remedy  that  has  given  the  best  results  has  been  the  hypodermic  injection 
into  the  gland  of  a  solution  of  iodine  (iodide  of  potassium,  2  parts;  tincture 
of  iodine,  2  parts;  and  water,  60  parts)  at  intervals  of  fourteen  days.  The 
solution  is  injected  through  the  rectum  directly  into  the  gland  by  means 
of  a  small  hypodermic  syringe. 

Castration  has  been  repeatedly  tried;  in  a  number  of  cases  it  has  pro- 
duced very  good  results  and  the  animal  was  greatly  relieved  from  active 
symptoms,  the  prostate  being  reduced  to  its  normal  size,  but  in  certain 
cases  the  animal  steadily  failed,  lost  flesh,  and  in  three  or  four  weeks 
became  a  skeleton  and  died  apparently  from  inanition. 

Tumor  of  the  Prostate. — Tumor  of  the  prostate  is  generally  carci- 
nomatous in  character,  causing  an  irregular  enlargement  of  the  gland, 
differing  from  the  symmetrical  enlargement  seen  in  hypertrophy  of  the 
gland;  this  aids  materially  in  reaching  a  diagnosis.  It  is  rather  diflficult 
at  times  to  make  a  diagnosis  where  only  the  general  indications  of  hyper- 
trophy of  the  prostate  are  seen,  that  is  difficulty  in  defecation  and  uri- 
nation, and  conclusions  can  only  be  based  on  the  general  health  of  the 
animal,  which  shows  a  gradual  want  of  nutrition.  Lienaux  recommends 
extirpation  of  the  prostate  (prostotomy)  even  in  simple  hypertrophy. 
Other  anomalies,  such  as  prostatic  calculi,  tuberculosis  of  the  prostate, 
have  no  particular  interest  and  need  not  be  taken  up  here. 


DISEASES  OF  THE  PENIS  AND  PREPUCE. 

Phimosis  and  Paraphimosis. — By  phimosis  we  mean  a  contraction 
of  the  prepuce  over  the  free  end  of  the  penis.  It  is  often  of  congenital 
origin,  and  is  occasionally  caused  by  injuries  and  consequent  cicatricial 
contraction;  l;)ut  as  in  the  dog,  the  foreskin  is  rarely  withdrawn,  it  is  of  little 
importance;  if ,  however,  the  contraction  is  so  complete  as  to  cause  retention 
of  a  certain  amount  of  urine;  the  retained  urine  decomposes,  and 
acts  as  an  irritant,  causing  inflammation  and  tumefaction  of  the  pre- 
puce. Phimosis  prevents  copulation,  and  as  soon  as  the  penis  is  erected, 
causes  paraphimosis.  Treatment  consists  in  making  a  longitudinal 
incision  on  the  median  line  of  the  prepuce  and  removing  a  certain  amount 
of  the  tissue  and  sewing  back  the  mucous  membrane.    Paraphimosis  is  the 


DISEASES  OF  THE  PEXIS  AND  PREPUCE  207 

condition  where  the  penis  passes  through  the  narrow  opening  of  the 
prepuce  the  gLans  becomes  swollen,  and  the  prepuce  becomes  tightened 
behind  the  glans  penis,  the  narrow  ring  of  the  prepuce  causes  venous 
engorgement,  becomes  oedematous,  causing  a  great  swelling  and  purple 
coloration  of  the  glans,  and  if  this  is  allowed  to  remain  some  time,  causes 
partial  gangrene.  The  above  phenomenon  is  seen  during  coitus  or  from 
erection  in  attempting  copulation,  from  traumatic  causes,  from  neoforma- 
tion,  or  paralysis  of  the  penis. 

The  therapeutics  of  paraphimosis  consists  in  reducing  the  glans  as 
soon  as  possible  with  friction  and  careful  manipulation;  this  is  accom- 
plished by  careful  lubrication  of  the  parts  with  some  bland  oil  and  putting 
a  steady  pressure  on  the  glans,  at  the  same  time  pressing  forward  the  pre- 
puce over  the  enlarged  part;  with  a  little  patience  it  is  reduced.  If  this 
is  not  successful,  bathe  the  glans  with  cold  water  or  alum  applications, 
lead  water,  sulphate  of  zinc,  or  wrap  the  protruding  portion  of  the  penis 
in  a  cold  bandage,  beginning  at  the  outer  end  and  quickly  wrapping  it 
around  the  distended  penis,  thus  forcing  the  blood  out  of  the  engorged 
glans,  then  as  the  bandage  is  removed  the  penis  is  returned,  drawing  the 
prepuce  over  it.  If  we  do  not  reduce  it  by  this  means,  then  cut  the  ring 
with  a  curved  probe-pointed  bistoury  or  a  pair  of  scissors.  It  can  then 
be  returned  immediately;  scarification  of  the  penis  is  rarely  necessary. 
In  extensive  necrosis  of  the  glans,  paralysis,  tumors,  etc.,  it  may  be  neces- 
sary to  remove  the  penis;  this  is  removed  by  a  circular  sweep  of  the  knife. 
If  the  penal  bone  is  to  be  cut  through  it  may  be  done  by  means  of  a 
pair  of  bone  forceps  or  sawed  through.  To  overcome  stenosis  of  the 
urethra  from  cicatricial  contraction  of  the  wound  the  urethra  is  opened 
about  0.5  cm.  and  sewed  back  of  the  wall  of  the  penis.  It  is  well,  how- 
ever, not  to  resort  to  this  until  you  have  tried  every  other  method. 

Gonorrhoea  of  the  Prepuce.  Preputial  Catarrh. — By  this  term  we 
mean  catarrhal  or  purulent  inflammation  of  the  mucous  membrane  of 
the  prepuce;  it  is  rather  common  in  dogs  that  are  well  fed;  it  is  harmless 
but  unsightly  from  the  discharge  of  yellow  mucus  constantly  dripping 
from  the  end  of  the  prepuce,  and  some  cases  are  extremely  obstinate  to 
treat.  It  may  be  caused  by  retention  of  urine,  phimosis,  calculi  of  the 
bladder,  prolonged  coitus,  dirt,  uncleanliness,  or  masturbation.  It  is 
frequently  observed  in  old  dogs,  due  in  their  case  to  stagnation  of  the 
veins  of  the  prostate.  The  symptoms  consist  in  slight  redness,  and 
swelling  of  the  prepuce  and  glans,  and  the  secretion  of  a  thin,  purulent 
mucus,  which  is  generally  licked  off  by  the  animal.  On  pushing  back 
the  prepuce,  the  lymph-follicles  are  generally  found  to  be  swollen, 
and  can  be  felt  on  manipulation  with  the  finger  as  small  bodies  about 
size  of  a  seed  or  pea.  In  rare  cases  the  inner  wall  of  the  prepuce  and  the 
bulbous  portion  of  the  glans  are  covered  with  papillary  excrescences. 


208      DISEASES  OF  THE  URIXARY  AND  SEXUAL  APPARATUS 

Rarely  or  over  in  this  condition  is  there  any  pain  on  pressure  of  the 
affected  parts.  The  treatment  consists  in  the  injection  of  acetate  of  lead 
water  or  1  per  cent,  solution  of  zinci  sulphas  or  argenti  nitras,  1  per  cent., 
or  claret  wine.  Before  making  the  medicinal  injection  it  is  well  to 
thoroughly  clean  out  the  prepuce,  with  repeated  sluicings  of  luke-warm 
water. 

The  disease  has  no  correlation  with  the  specific  gonnrrhan  of  man,  l)ut 
in  rare  cases  we  may  find  an  animal  affected  with  gonorrhcsa  which  has 
extended  from  the  foreskin  into  the  urethra  and  an  enlargement  of  the 
inguinal  lymphatics,  forming  a  bubo.  In  one  of  the  cases  observed  by 
Siedamgrotzky,  the  gonorrhoea  was  accompanied  by  intense  inflammation 
of  the  eyes. 

Neoformations  of  the  Glans  and  Prepuce. — Xeoformations  are  some- 
times found  on  the  dog  and  are  either  papilloma,  carcinoma,  or  sarcoma. 
These  appear  in  a  variety  of  forms — warty  or  corrugated,  sometimes 
pedunculated  but  generally  with  broad  bases,  hard  or  soft  and  bleeding 
easily  to  the  touch,  situated  on  the  penis  or  prepuce,  visible  only  when 
the  prepuce  is  retracted  except  in  rare  cases  when  they  are  situated  on  the 
external  opening  of  the  prepuce  and  protrude  beyond  the  opening.  There 
may  be  a  more  or  less  abundant  discharge  of  purulent  mucus,  stained 
occasionally  with  blood.  (For  infectious  genital  tumors,  see  under  that 
head.)  The  papilloma  can  be  removed  by  the  scissors  or  a  small  pair  of 
forceps,  and  the  blood  stopped  by  compression  or  a  solution  of  alum,  or, 
what  is  much  better,  the  thermo-cautery.  Albrecht  recommends  that 
the  tumor  he  touched  daily  with  a  solution  of  chromic  acid  1  to  30.  Car- 
cinoma and  sarcoma  generally  require  the  removal  of  a  portion  of  the 
glans.     (See  chapter  on  Neoformations.) 


DISEASES  OF  THE  TESTICLE  AND  ITS  COVERINGS. 

Inflammation  of  the  Scrotum. — We  frequently  see  inflammatory 
conditions  of  the  scrotal  covering  as  a  result  of  contusions;  they  may, 
however,  be  caused  by  eczema,  which  sometimes  causes  great  swelling 
and  sensitiveness,  the  animal  walking  with  a  peculiar  stradling  gait;  this 
condition  may  involve  the  entire  scrotal  sac,  and  on  account  of  the  irrita- 
tion of  the  tissues  from  the  animal  constantly  licking  and  biting  affected 
part,  it  is  very  slow  in  healing,  and  frequently  covers  over  a  long  period  of 
time  before  making  a  complete  recovery.  Occasionally  partial  necrosis 
occurs,  followed  by  sloughing  of  a  portion  of  the  scrotum.  (See  Diseases 
of  the  Skin,  under  Eczema.)  Moller  has  also  seen  serpentine  varicosis  of 
the  scrotum  with  ulceration  and  accompanied  with  profuse  hemorrhage. 
Treatment:  Keep  the  animal  in  a  dry  kennel  or  let  it  He  on  a  cushion  and 


INJURIES  TO  THE  TESTICLES  AND  SCROTUM  209 

prevent  the  rulilnng  on  an}-  rough  ol)ject  and  apply  oxide  of  zinc,  talcum 
powder,  bismuth  preparations,  or  boracic  acid,  and  the  animal  must  be 
restrained  from  licking  or  irritating  the  affected  portions,  either  by  means 
of  a  muzzle  or  the  scrotum  covered  by  a  Priessnitz  bandage.  If  necrosis 
develops  as  a  result  of  the  condition  just  described  or  from  traumatisms  or 
freezing,  etc.,  and  the  sloughed  portion  is  very  extensive  it  may  be  neces- 
sary to  castrate  the  animal  as  well  as  remove  the  necrosed  portion. 

Inflammation  of  the  Testicle — Orchitis. — Orchitis  without  any  other 
injury  is  very  rarely  seen  in  the  dog;  it  may  be  caused  by  a  kick,  or  a  blow, 
or  from  crushing  or  by  metastasis  from  acute  inflammatory  conditions  of 
the  adjacent  urinary  organs.  The  testicle  is  hot,  swollen  and  smooth  on 
its  surface  and  very  sensitive  to  the  touch;  the  animal  walks  with  its  hind 
legs  wide  apart,  and  sometimes  there  is  fever  and  loss  of  appetite.  In  the 
majority  of  cases,  the  irritation  subsides  quickly,  and  the  animal  is  well  in 
a  few  days;  in  rare  instances,  the  irritation  is  followed  by  suppuration  and 
the  formation  of  more  or  less  pus,  the  abscess  points,  breaks  through  the 
scrotum  and  discharges.  In  acute  cases,  on  the  subsidence  of  the  acute 
symptoms  it  is  followed  by  induration  of  the  testicle  and  that  body  becomes 
firm  and  irregular  on  its  surface.  In  one  case  that  the  writer  observed  the 
epididymis  was  also  greatly  swollen  (epididymitis).  The  therapeutics 
consists  of  warm  applications  and  rest,  paint  with  tincture  of  iodine  and 
apply  a  well-padded  suspensory  bandage  over  the  scrotum.  When  the 
effects  of  the  iodine  have  passed  off  apply  salicylic  acid  ointment.  If  sup- 
puration has  commenced,  it  should  be  encouraged  as  much  as  possible  with 
warm  applications  and  poultices  and  opened  as  soon  as  the  abscess  has 
pointed,  cleaned  out  with  corrosive  sublimate  solution,  and  treated  as  an 
open  wound.  There  is  no  treatment  that  will  have  any  permanent 
effect  in  chronic  orchitis. 

Injuries  to  the  Testicles  and  Scrotum. 

As  a  rule,  the  wounds  of  these  parts  are  caused  by  fighting  with  other 
dogs,  and  are  either  lacerations  or  perforated  wounds.  In  the  majority 
of  cases,  try  to  get  drainage  and  keep  the  w^ound  clean  by  means  of  anti- 
septics; this  is  best  accomplished  by  putting  a  piece  of  absorbent  cotton 
saturated  with  the  solution  on  the  scrotum,  and  by  means  of  a  long-tailed 
bandage  tied  around  the  body  the  cotton  can  be  kept  in  place.  Where 
the  testicle  is  badly  injured,  the  gland  had  better  be  removed  by  castra- 
tion, as  it  is  only  in  favorable  cases  that  the  animal  makes  a  good  recovery 
and  the  seminal  power  is  retained. 

(For  further  details  on  the  subject  consult  the  chapter  on  Hernia  of 
the  Testicles  and  Castration.) 

Neoformations  of  the  Testicles. — Omitting  tuberculous  deposits,  we 

14 


210      DISEASES  OF  THE  URIXARY  AND  SEXUAL  APPARATUS 

find  fibroma,  sarcoma  and  carcinoma;  the  former  can  easily  be  felt  on  the 
surface  of  the  testicle  as  distinct  circumscribed  elevations;  the  latter  two 
on  the  other  hand  are  indicated  by  a  hypertrophy  of  the  testicles  and  the 
spermatic  cord  may  be  involved,  and  in  rare  cases  both  testicles  are  affected. 
The  testicle  may  be  greatly  enlarged,  the  surface  smooth  or  it  may 
be  uneven  and  irregular.  Rarely  do  these  neoformations  involve  the 
scrotum;  when  they  do,  they  form  adhesions  and  if  they  make  an  external 
opening  in  the  scrotum  Kitt  has  observed  that  it  is  extremely  difficult  to 
distinguish  by  microscopical  examination  the  true  pathological  character 
of  these  hypertrophied  testicles  and  place  them  in  their  proper  class 
(Orchidarm,  Orchidoblastom).     Fig.  84  represents  one  of  these  tumors. 


Fig.  84. — Enlargement  of  scrotum. — Orchitis. 


Castration  is  the  only  radical  method  to  remove  these  malignant  tumors 
and  it  should  be  done  early  before  the  entire  region  becomes  involved. 

Castration  of  the  Male. — The  animal  is  prepared  by  washing  the 
region  of  operation  with  an  antiseptic  solution,  put  the  animal  under 
ether  or  inject  the  region  with  4  per  cent,  cocaine,  turn  him  on  his  l:)ack,  an 
incision  is  made  in  a  longitudinal  direction  through  the  skin  of  the  scrotum 
and  vaginal  tunic,  and  the  posterior  portions  of  the  cord  are  cut  through 
and  the  anterior  or  vascular  portion  is  ligated  with  silk  and  cut  through 
just  below  the  ligature  and  the  other  testicle  treated  in  the  same  manner 
(Fig.  92);  in  young  animals  the  cord  is  simply  scraped  through  or 
twisted  off  by  means  of  tortion,  and  the  opening  in  the  scrotum  closed  by 


INFLAMMATION  OF  THE   VAGINA  211 

means  of  a  stitch,  and  covered  with  a  (Hsinfectant  dusting  powder,  and  a 
truss  bandage  apphed.  The  wound  is  dressed  ch^ily,  it  heals  up  rapidly. 
It  is  well  not  to  allow  the  bandage  to  remain  on  too  long,  as  it  is  apt  to 
irritate  the  animal.  Another  znode  of  procedure  is  to  make  an  incision  on 
the  median  line  of  the  scrotum,  but  before  doing  so  tie  a  string  around 
the  scrotum  just  above  the  testicles,  so  that  when  the  incision  is  made  the 
testicle  will  not  be  tlrawn  beyond  reach;  having  made  the  incision  on  the 
median  line,  cut  through  the  tunica,  draw  out  both  testicles,  twist  them 
round  several  times,  making  a  spiral  of  the  cords,  then  cut  the  cords  as 
high  up  as  possible  with  the  ecraseur  or  a  pair  of  emasculating  scissors. 
The  hemorrhage  is  slight  and  much  better  than  the  complication  of  the 
ligature  hanging  in  the  wound. 

Cuterebro  Emasculator. 

(Emasculating  Bot  Fly.) 

This  parasite  which  is  frequently  observed  in  squirrels  and  occasion- 
allv  in  rabbits  has  been  observed  in  two  cases  in  the  dog  where  the  grulj  of 
the  parasite  was  found  imbedded  in  the  scrotum.  These  were  in  English 
setters  and  the  dogs  had  been  in  the  Southern  states  for  some  time. 

The  scrotum  swells  slowly,  beginning  at  the  dependent  portion,  until 
a  round,  firm  mass,  resembling  in  size  and  shape  of  the  ordinary  "  warble'' 
seen  in  cattle's  backs,  but  not  quite  so  large;  it  apparently  gives  the  ani- 
mal no  discomfort  unless  the  parasite  should  act  as  an  irritant  and  form 
an  abscess;  when  this  occurs  it  is  followed  by  great  irritation  of  the  parts, 
and  subseciuently  sloughing  of  a  portion  of  the  scrotum  and  destruction  of 
the  testicle.  The  treatment  consists  in  finding  the  opening  or  vent  of  the 
parasite  in  the  skin  and  carefully  enlarging  it,  taking  care  not  to  penetrate 
the  larva,  when  it  can  be  pushed  out  and  the  wound  cleaned  with  a  solu- 
tion of  peroxide  of  hydrogen.  If  the  grub  is  punctured  and  it  collapses, 
the  remaining  portion  of  the  parasite  must  be  carefully  removed,  as  it 
causes  great  irritation  if  allowed  to  remain.  Dress  daily  with  a  1  to  3000 
solution  of  corrosive  sublimate. 

DISEASES  OF  THE  FEMALE  SEXUAL  ORGANS. 

DISEASES  OF  THE  VAGINA  AND  THE  UTERUS. 
INFLAMMATION  OF   THE  VULVA  AND  VAGINA. 

{Vulvitis  and    Vayinitis.) 

Inflammation  of  the  vulva  and  vagina  results,  as  a  rule,  from  difficult 
labor  or  unskilled  assistance  during  delivery,  and  in  rare  cases  as  a  result 
of  improper  copulation,  or  when  young  bitches  or  very  delicate  animals 


212      DISEASES  OF  THE  URINARY  AND  SEXUAL  APPARATUS 

are  having  their  first  littoi-s.  In  the  acute  form  the  Labia  pudendi  are 
tumefied  and  painful  to  the  touch.  The  condition  is  indicated  by  a 
whitish,  purulent  discharge,  in  some  cases  being  foetid,  which  is  generally 
licked  off  by  the  animal.  The  examination  in  the  larger  animals  can  be 
made  by  means  of  a  speculum  (Fig.  85) .  On  examination  of  the  vagina 
we  find  it  intensely  red  and  inflamed  and  covered  with  a  gray- 
ish, mucous  discharge;  the  mucus  is  also  grayish  in  color,  and 
has  in  some  cases  striated  lines  or  petechial  patches.  In 
chronic  cases  there  is  a  constant  discharge  from  the  vulva  of 
a  whitish-yellow  muco-purulent  fluid  which  agglutinates  the 
hair  in  that  region,  and  the  animal  is  constantly  licking  the 
discharge;  the  mucus  is  sometimes  grayish  in  color,  and  car- 
cinoma is  often  present.  (8ce  chapter  on  Tumors  for  further 
details.) 

The  therapeutic  treatment  consists  of  daily  injections  and 
irrigations  of  astringent  or  disinfectant  washes  of  sulphate  of 
zinc    (1   per  cent.),  or  permanganate  of  potassium  solution, 
boric  acid,  or  creolin,  lysol,  bacillol,  etc.,  or  a  solution  of  acacia  (mucil- 
age) is  useful.     In  chronic  cases  use  nitrate  of  silver,   1  per  cent,  solu- 
tion, or  sulphate  of  zinc,  2  to  100  solution. 


Prolapse  of  the  Vagina  and  Uterus. 

{Prolapsus  Vagince;  Prolapsus   Uteri.) 

Prolapse  of  the  vagina  is  more  common  than  prolapse  of  the  uterus; 
it  is  seen  especially  in  young  bitches,  frequently  at  the  termination  of  heat 
and  occasionally  at  the  latter  period  of  pregnancy;  it  rarely  occurs  as  a 
result  of  parturition.  In  some  instances  it  is  accompanied  by  serious 
alterations  of  the  vagina,  especially  hypertrophic  alterations,  and  also  in 
rare  cases  we  find  polypus  formations.  As  a  rule  there  is  more  or  less 
protrusion  of  the  vagina  through  the  vulva,  appearing  in  the  form  of  pear- 
or  flap-shaped,  red,  inflamed  tissue  covered  with  mucus  (Fig.  86).  In 
very  rare  instances  the  prolapse  is  so  great  that  the  os  of  the  vagina  can 
be  seen  through  the  external  opening.  When  the  vagina  has  been  parti- 
ally prolapsed  for  some  time,  the  exposed  portion  becomes  so  infiltrated 
and  hypertrophied  that  it  becomes  impossible  to  reduce  it.  Care  must 
be  taken  to  differentiate  between  a  pedunculated  fil^roma  and  the  pro- 
lapsed vagina,  and  instances  are  not  rare  where  the  vagina  is  prolapsed 
and  a  tumor  whose  existence  is  never  suspected  also  accompanies  it. 

The  prolapse  of  the  uterus  in  the  dog  is  practically  impossible,  for  the 
reason  that  the  uterus  itself  is  merely  a  body  in  name,  and  really  the  uterus 


PROLAPSUS  OF  THE  VAGINA  AND  UTERUS 


213 


consists  in  the  horns,  the  true  body  of  the  uterus  being  a  small  body  from 
which  the  horns  bifurcate  almost  at  the  os  (Fig.  87). 

The  therapeutics  of  prolapse  of  the  vagina  is  practically  that  used  in 
prolapse  of  the  anus  and  rectum.  In  slight  cases  after  copulation,  the 
animal  should  be  kept  quiet,  and  it  will  then  soon  disappear;  the  applica- 
tion of  vaseline  or  boracic  acid  ointment,  however,  may  be  used.  The 
retention  of  the  vagina  is  much  more  difficult  than  returning  it  to  its  nor- 
mal position;  the  protruded  portion  is  carefully  washed  with  warm  water 
and  an  antiseptic  solution  of   boracic  acid  or  creolin  solution  and  the 


Fig.  86. — Prolapse  of  the  vagina. 


animal  placed  so  that  the  hind  quarters  are  elevated  for  at  least  an  hour. 
If  there  is  great  tumefaction,  the  protruded  portion  must  be  massaged 
for  some  time  to  lessen  the  volume  of  the  enlargement  before  attempting 
to  reduce  it.  If  that  is  not  sufficient,  and  the  protrusion  recurs  in  a  short 
time,  it  is  well  to  introduce  a  tampon  into  the  vagina  or  pack  the  vagina 
with  antiseptic  gauze  or  cotton  and  stitch  the  lips  of  the  pudenda  in  such  a 
manner  as  not  to  interfere  with  the  normal  passage  of  urine,  and  assist 
defecation  and  prevent  straining  by  the  administration  of  laxatives  or 
using  glycerine  suppositories.  The  writer  generally  uses  the  following 
method:  After  returning  the  vagina  to  the  normal  position,  he  puts  two 
stitches  in  the  pudenda  and  leaves  them  there  for  three  days,  when 
they  are  removed. 

In  one  case  where  there  was  great  thickening  of  the  walls  of  the  vagina 


214      DISEASES  OF  THE  URIXARY  AND  SEXUAL  APPARATUS 

and  reduction  of  the  prolapse  was  impossible,  and  another  where  the 
vagina  prolapsed  immediately  after  the  stitches  were  removed  after  being 
there  for  several  days,  the  writer  performed  a  partial  amputation,  taking 
out  an  elongated  piece  of  mucous  membrane  and  sewing  it  up  by  a  continu- 
ous stitch  of  cat-gut,  which  was  followed  by  good  results. 


Fig.  87. — The  genito-urinarj'  organs  of  the  bitch:  a,  ovary  covered  M^ith  capsule;  b,  capsule  of  ovarj^; 
c,  ovary;  d,  horns  of  the  uterus;  e,  body  of  the  uterus;  /,  os  uteri;  g,  vagina;  g,  opening  of  the  urethra; 
h,  clitoris;  i,  i,  vulva;  /,  bladder;  ??;,  urethra. 


Reduction  of  the  uterus  is  much  more  difficult,  and  in  the  majority  of 
cases  it  is  impossible  except  by  laparotomy.  The  prolapsed  portion 
should  be  lubricated  and  gradually  worked  back,  and  after  the  fingers  can- 
not reach  any  further,  a  tallow-candle  must  be  inserted  and  the  horn  pushed 
back  as  far  as  possible.  If  this  method  is  not  successful,  laparotomy 
should  be  performed  in  the  manner  spoken  of  in  hernia.     An  incision  is 


DISEASES  OF  THE   UTERUS  215 

made  into  the  abdominal  wall  and  the  finger  inserted  until  the  Fallopian 
tube  is  felt,  and  then  the  animal  is  held  up  by  the  posterior  extremities, 
and  by  gradual  tension  the  horn  of  the  uterus  is  pulled  back  into  position 
and  the  opening  in  the  abdomen  is  closed.  The  rules  named  for  retaining 
the  vagina  are  then  to  be  followed.  The  viterus  can  be  retained  in 
position  In'  making  an  opening  in  the  median  line  of  the  abdomen  and 
pulling  the  horn  into  position  and  then  stitching  the  horn  to  the  upper 
part  of  the  abdominal  wall.  It  is  needless  to  say  that  the  stitch  must  be 
of  cat-gut. 

Neoformations  of  the  Vagina. — The  tumors  found  in  the  uterus  are 
fibroma,  papilloma,  and  carcinoma.  The  fibrous  are  frequently  observed; 
they  may  appear  either  singly  or  multiple,  varying  from  the  size  of  a  pea 
to  as  large  as  an  egg;  they  are  hard,  smooth  on  the  surface  and  usually 
pedunculated,  occasionall}'  protruding  from  the  vaginal  opening,  and  are 
not  at  all  sensitive. 

The  papilloma  are  rarer,  found  generally  at  the  interior  of  the  vagina 
and  in  the  form  of  warty,  irregular  elevations  resembling  a  raspberry,  or, 
if  larger,  a  cauliflower;  the  tumors  closely  resemble  true  carcinoma,  so  rare 
in  the  dog.  Of  true  cancer  the  writer  has  observed  only  one  case  in  a  St. 
Bernard;  this  neoplasm  occupied  the  inferior  lateral  floor  of  the  vestibule 
of  the  vulva;  it  was  soft  and  spongy,  irregular  in  form,  bleeding  easily  to 
the  touch,  foetid  in  odor,  the  cancer  had  a  broad  base,  was  hard  and  indu- 
rated, and  extended  some  distance  into  the  tissues.  True  cancer  is  very 
rare  and  is  indicated  by  a  foetid  ichorous  discharge  from  the  vagina.  The 
vagina  can  either  be  examined  by  the  introduction  of  the  index  finger,  or 
using  a  speculum.  Frohner  advises  digital  examination.  The  cancers 
occur  in  single  or  multiple  groups,  soft  excrescences  attached  to  the  mu- 
cous membrane  of  the  vagina  which  are  not  painful  to  the  touch  but  bleed 
easily  on  manipulation.  These  cancers  vary  in  form;  some  are  rough 
with  irregular  elevations  like  a  cauliflower;  they  may  be  polypus  in  shape, 
or  they  may  occur  as  a  diffuse  mass  of  irregular  infiltrations  spread  over 
the  mucous  membrane  of  the  vagina.  Where  it  can  be  clone  these 
tumors  should  be  removed  as  early  as  possible. 

DISEASES  OF  THE  UTERUS. 

Inflammation  of  the  Uterus  (Metritis). — It  is  a  common  occurrence 
to  have  inflammation  of  the  uterus  after  protracted  labor.  The  disease 
can  be  subdivided  into  the  following  varieties,  catarrhal  and  septic, 
according  to  the  exciting  causes: 

(1)  Catarrhal  Metritis.  Superficial  Metritis,  Catarrh  of  the  Uterus. — In 
this  condition  the  disease  is  limited  to  the  mucous  membrane  and  presents 
the  same  symptoms  as  are  seen  in  all  catarrhal  inflammations  of  mucous 


216       DISEASES  OF  THE   URIXARY  AND  SEXUAL  APPARATUS 


membranes;  the  course  may  be  acute  or  become  chronic;  the  causes  are 
miechanical  injuries  which  the  uterus  may  be  subjected  to  during  labor 
or  immediately  after;  cold  may  be  said  to  be  a  predisposing  cause. 

The  clinical  symptoms  are  as  follows:  The  vulva  is  slightly  red- 
dened and  swollen,  and  there  is  a  copious  discharge  from  the  vulva;  this  is 
purulent,  sometimes  bloody  or  slightly  putrid,  and  is  much  increased  in 
quantity  after  the  passage  of  feces  or  urine;  but  the  animal  licks  it  off  so 
soon  that  the  observer  must  look  immediately  after  each  evacuation  or  it 
may  escape  his  notice.  Some  bitches  carry  their  tails  in  a 
curved  position  when  suffering  from  this  condition,  are 
uneasy  and  occasionally  strain;  some  animals  have  com- 
plete loss  of  appetite,  and  in  some  cases  slight  fever  is 
present.  As  a  rule,  the  discharge  lessens  and  disappears  in 
a  few  weeks  or  it  may  become  chronic,  and  there  is  an  abun- 
dant discharge  of  white  or  whitish-yellow  purulent  creamy 
fluid  (leukorrlnea,  fluor  albus) ;  the  animal  becomes  emaci- 
ated, loses  flesh  and  has  a  stairy,  rough  coat.  In  some 
cases  there  is  a  gradual  swelling  and  obstruction  of  the  os 
uteri,  the  purulent  material  is  held  in  the  uterus  (pyo- 
metra),  pyemia  develops,  and  death  occurs  in  a  short  time. 
External  manipulation  through  the  abdominal  wall  may 
find  the  uterus  greatly  increased  in  volume,  and  on  digital 
examination  per  rectum  the  vagina  is  found  to  be  drawn 
into  the  abdominal  cavity. 

The  therapeutics  consist  in  tepid  injections  of  non- 
Double  catheter  poisonous  autiscptic  fluids,  such  as  permanganate  of  po- 
^"th'e^'u'tiL"''^  tassium  (1  per  cent,  solution),  boric-acid  (2  per  cent.),  and 
creolin  (1  per  cent.),  tannic  acid  (2  percent.),  solution  of 
corrosive  sublimate  (1  to  2000.)  In  using  these  solutions  it  is  best  to  use 
the  irrigator  with  the  two  catheters  (Fig.  88) ;  in  one  opening  the  fluid  is 
forced  through  into  the  uterus  and  allowed  to  circulate  and  flow  out  of 
the  other  opening.  The  uterus  must  first  be  thoroughly  rinsed  out  with 
luke-warm  water  before  the  medicinal  irrigations  are  applied.  If  the  os 
uteri  is  contracted,  it  can  be  dilated  by  means  of  a  bougie.  In  the 
chronic  form  (dysmenorrhcea)  we  should  use  injections  of  ergot  or  sabine 
oil.  In  chronic  cases,  with  persistent  foetid  discharge,  the  uterus  should 
be  removed. 

(2)  Septic  Metritis.  Gangrenous,  Ichorous  Inflammation  of  the  Uterus 
{Puerperal  Fever). — Septic  inflammation  of  the  uterus  should  be  con- 
sidered a  disease  of  wound  infection  in  which  we  find  intense  irritation  of 
the  uterus  and  vagina,  accompanied  by  violent  constitutional  disturbances. 
During  and  after  labor  septic  materials  find  their  way  into  the  uterus 
and,  owing  to  the  condition  of  the  uterus  at  that  time,  when  it  is  practi- 


Fig.  SS. 


DISEASES  OF  THE   UTERUS  217 

call}^  in  the  same  condition  as  an  open  wound,  the  septic  materials  are 
taken  up  very  quickly  and  every  condition  is  favorable  for  their  propaga- 
tion. Collections  of  blood,  decidual  tissue,  etc.,  exposed  to  the  air  decay 
very  ciuickly,  and  where  there  is  any  erosion  of  the  mucous  membrane  of 
the  vagina  or  the  cervix,  or  even  the  uterus  at  the  points  of  placental  at- 
tachment, the  poison  is  taken  up  and  enters  the  tissues  and  is  carried  into 
the  circulation.  The  eroded  portion  of  the  uterus  that  has  taken  up  any 
of  the  septic  material  soon  presents  an  ulcerated  surface  which  is  covered 
by  a  necrotic  or  diphtheritic  coating,  and  in  some  cases  the  vagina  be- 
comes intensely  swollen,  is  dark  brown  or  reddish-brown  in  color,  and 
covered  with  spots  of  diphtheritic  ulcerations. 

The  inflammatory  process  extends  rapidly  from  the  mucous  mem- 
])rane  into  the  deeper  tissues,  affecting  the  muscular  and  the  pelvic  cellu- 
lar tissues,  and  also  the  lips  of  the  pudenda,  and  from  the  internal  surface 
of  the  uterus  it  extends  to  the  uterine  muscles  and  the  broad  ligament, 
and  in  acute  cases  to  the  serous  covering  of  the  uterus  and  the  peritoneum. 
When  the  acute  symptoms  are  present  (perimetritis  and  parametritis) 
ptomaines  and  septic  material  enter  the  circulation  and  cause  acute  septic 
fever.     The  prognosis  is  generally  unfavorable. 

Clinical  Symptoms. — The  vulva  and  the  mucous  membrane  of  the 
vagina  are  swollen  and  livid  red,  and  discharge  copious  masses  of  dis- 
colored, fcEtid  pus.  In  the  earlier  stages  the  animal  shows  great  pain  on 
pressure  to  the  abdomen;  the  pulse  is  very  fast,  thready  and  finally  be- 
comes imperceptible.  The  respirations  increase  in  number.  The  tempera- 
ture in  the  early  stages  is  increased,  but  soon  falls,  becoming  subnormal 
toward  the  end.  The  mucous  membranes  of  the  mouth  and  conjunctiva 
are  livid,  an  offensive  diarrhoea  commences,  and  the  expired  air  from  the 
lungs  smells  of  decayed  tissue. 

When  the  animal  presents  the  acute  symptoms  early  and  does  not  eat 
or  drink  from  the  onset,  it  soon  becomes  comatose  and  dies  in  from  twelve 
to  twenty-four  hours. 

Therapeutics. — In  such  cases  to  get  any  favorable  results  treatment 
must  be  prompt  and  energetic.  The  uterus  and  the  vagina  must  be 
thoroughly  irrigated  with  antiseptic  fluids,  and  also  the  general  treatment 
indicated  in  septicaemia.  For  antiseptic  irrigating  fluids  we  use  creolin, 
2  per  cent,  solution;  lysol,  1  to  100;  actol  (1  to  1000) ;  formalin  (2  to  50); 
corrosive  sublimate,  1  to  2000  solution.  First  irrigate  the  uterus  with  warm 
water  using  the  double  catheter  shown  in  Fig.  88,  and  clean  it  thoroughly 
until  there  is  no  discoloration  in  the  escaping  fluids;  then  inject  the  medi- 
cated solution  into  the  uterus  several  times;  repeat  this  several  times  daily. 
As  a  stimulant,  use  whiskey,  brandy,  camphor,  either  internally,  or  sub- 
cutaneously;  the  latter  is  best,  as  you  are  apt  to  get  quicker  results,  and 
you  also  avoid  the  danger  of  the  animal  vomiting  it,  which  it  is  very  apt  to 


218      DISEASES  OF  THE  URINARY  AND  SEXUAL  APPARATUS 

do.      Ergot  or  caffein  are  used  with  some  success  where  there  is  great 
weakness  of  the  heart. 

I^.     Camphor  pulv.,  0.2 

Gummi  acacia,  0.6 

F.  chart.  No.  xii., 
S. — One  powder  every  two  hours. 

Prolapse  of  the  Uterus.  Prolapsus  Uteri. — This  condition  is  ex- 
tremely rare  and  occurs  only  during  or  immediately  after  delivery.  From 
very  severe  traction  during  labor  or  awkward  assistance,  particularly  of 
the  last  foetus,  the  horn  of  the  uterus  everts,  passes  beyond  the  os  uteri 
and  vagina  (invertio  uteri  without  prolapse,  incomplete  prolapse  of  the 
uterus)  or  passes  entirely  beyond  the  vulva  and  generally  carries  also  a 
portion  of  the  uterus  with  it.  It  protrudes  out  of  the  vulva  in  the  form  of 
a  tumor-like  mass,  the  mucous  membrane  being  tumefied  and  livid 
in  color.  The  membrane  may  be  excoriated  in  places  and  in  ex- 
treme cases  gangrenous. 

Treatment. — This  is  practically  the  same  as  prolapse  of  the  vulva  or 
rectum.  The  protruded  portion  is  carefully  bathed  with  mild  antiseptic 
solutions  such  as  boracic  acid  and  endeavor  to  return  it  to  its  normal 
position  by  even  pressure  of  the  fingers;  if  this  succeeds,  place  the 
animal  so  that  the  hind  quarters  will  be  slightly  elevated,  inject  a  solution 
of  boracic  acid  into  the  uterus,  and  followed  by  a  hypodermic  injection  of 
morphia  which  tends  to  overcome  straining  on  the  part  of  the  animal.  If 
the  prolapse  recurs  it  may  be  reduced  and  a  sponge  or  oakum  tampon 
inserted  into  the  vagina  and  the  orifice  closed  with  sutures  (see  page.  213). 
If  the  uterus  persists  in  resisting  the  above  mentioned  treatment,  the 
animal  should  be  etherized,  the  abdomen  opened  on  the  median  line,  and 
the  uterus  or  Fallopian  tube  drawn  down  to  the  opening  and  tied  to  the 
abdominal  opening  by  means  of  sutures,  taking  care  not  to  include  the 
mucous  coat  of  the  intestines  in  the  stitch.  If  gangrene  has  set  in,  the 
exposed  uterus  must  be  amputated.  The  exposed  portion  of  the  uterus 
is  drawn  out,  ligatured  with  strong  silk  thread,  and  the  dependent  portion 
cut  off  just  below  the  suture;  care  must  be  taken  not  to  include  the 
bladder  or  the  urethra,  and  the  stump  pushed  back  into  the  pelvic  cavity; 
some  operators  advise  an  elastic  ligature.  Cutting  off  the  prolapsed,  por- 
tion by  means  of  an  ecrasour  is  not  to  be  advised. 

Neoformations  of  the  Uterus. — Fibromas  are  found  most  frequently  in 
the  uterus  and  sometimes  reach  to  a  considerable  size.  Cyst  sarcoma  and 
carcinoma  are  also  seen;  the  latter  are  generally  found  in  the  form  of  soft, 
loosely  organized  masses,  filling  up  the  entire  lumen  of  the  uterus,  occasion- 
ally involving  the  adjacent  organs  (the  intestines  and  bladder) .  The  only 
radical  means  of  treatment  is  to  extirpate  the  entire  uterus.     The  sub- 


OBSTETRICS  219 

cutaneous  injection  of  ergot  in  had  been  found  to  check  the  growth  of 
myofibroma  and  in  some  cases  to  remove  it. 

Obstetrics. 

As  a  rule,  the  Intch  has  her  pups  without  any  difficulty.  The  period 
of  pregnancy  varies  from  fifty-eight  to  sixty-two  days  (Dun  kept  a 
record  of  189  bitches  and  found  the  average  period  Avas  03.28  days,  the 
maximum  being  seventy-one  days  and  the  minimum  being  fifty-three 
days)  when  she  generally  seeks  a  cjuiet  place  and  drops  from  one  to  eight 
(sometimes  more)  blind  pups,  which  open  their  eyes  in  from  ten  to  twelve 
days,  the  period  of  whelping  being  from  one  to  six  hours  (quite  frequently 
lasts  ten  to  twelve  hours),  in  rare  eases  eighteen  to  twenty-four  hours. 
The  labor  pains  generally  appear  from  three  to  ten  hours  before  birth,  and 
are  indicated  by  the  bitch  being  very  restless,  going  into  dark  corners,  or 
scratching  as  if  to  make  a  bed,  she  whimpers,  moans,  groans,  assumes  the 
position  as  if  urinating  or  defecating,  and  frequently  passes  small  amounts 
of  urine,  and  on  putting  the  hand  on  the  abdominal  walls,  the  foetuses  are 
found  to  be  showing  considerable  movement.  The  retention  of  the  whole 
or  a  portion  of  the  placenta  is  very  rare  in  the  bitch,  and  when  it  does  occur 
it  is  indicated  by  the  following  symptoms: — great  depression;  no  milk  in 
the  mammse;  the  bitch  pays  no  attention  to  the  pups;  frequent  contraction 
of  the  uterus  similar  to  labor  pains;  entire  loss  of  appetite;  pain  on  pres- 
sure of  the  abdomen.  The  temperature  was  normal  at  first,  l;)ut  gradually 
increased;  the  pulse  was  c^uick  and  hard,  and  a  fcetid  discharge  from  the 
vulva. 

The  short  but  strong  umbilical  cord  is  torn  during  labor  or  bitten  off  by 
the  bitch  immediately  after  birth,  and  the  entire  mass  of  placenta  and 
amnion  is  eaten  by  the  mother.  After  the  birth  of  the  pups  there  is  slight 
lochial  discharge,  bloody  in  the  onset  and  finally  purulent;  this  discharge 
lasts  for  several  days. 

The  normal  course  of  birth  may  be  changed  by  the  following  condi- 
tions: 1.  The  labor  pains  may  not  be  strong  enovigh.  2.  There  may  be  a 
narrow,  contracted  pelvis.  3.  The  vagina  may  be  lessened  in  diameter 
])y  cicatricial  contractions,  tumors,  etc.  4.  The  foetus  may  be  very 
large,  a  monstrosity.  5.  Foetus  may  be  presented  in  an  irregular  posi- 
tion. 6.  Torsion  of  the  horn;  this  is  extremely  rare.  As  a  rule,  the 
bitch  does  not  require  the  assistance  of  the  veterinarian,  although  very 
small  animals  and  the  higher  bred  animals  may  need  some  assistance, 
Init  it  is  best  to  leave  the  bitch  as  quiet  as  possible  and  not  to  interfere 
with  her  in  any  way.  Small  bitches  sometimes  have  very  large  pups, 
the  size  of  the  male  has  also  an  effect  on  a  litter.  When  the  labor  pains 
are  weak  or  entirely  absent,  an  examination  of  the  uterus  is  made  by 


220      DISEASES  OF  THE  URINARY  AND  SEXUAL  APPARATUS 


introducing  the  index  finger,  well  oiled,  into  the  vagina,  the  other  hand 

putting  pressure  on  the  abdominal  wall;  and  if  we  find  the  foetus  is  in 

position,  the  head  is  felt  in  the   dilated  os  (the  breech   presentation  is 

also  seen,  but  is  rare)  and  the  pelvic  cavity  normal,  artificial  assistance 

is  contraindicated,  at  least  for  an  hour  or  two;  if  at  the  end  of  that  time 

the  head  has  not  advanced,  ergot  must  be  given  inter- 

'tfT  a^       nally  or,  subcutaneously,  massage  of  the  uterus  through 

ij  the  abdominal  wall,  and  applications  of  warm  cloths  to 

'   '  the  abdomen. 

One  writer  speaks  very  highly  of  glycerine  in  1  to 
10  solution  with  warm  w'ater  as  an  agent  to  encourage 
the  contraction  of  the  uterus  in  cases  of  difficult  part- 
urition; it  is  injected  directly  into  the  uterus.  If  the 
animal  is  depressed  and  weak,  administer  stimulants — 
whiskey,  wine,  or  alcohol  or  spirits  of  camphor  internally 
or  subcutaneously — and  if  these  fail  to  produce  the  birth 
of  the  foetus  it  may  have  to  be  removed  by  forceps,  of 
which  there  are  a  variety,  the  simplest  of  which  are  the 
most  useful,  hooks — (Fig.  89). — or  the  foetus  may  be 
noosed  by  means  of  a  coj^per  wire  or  cotton  cord  held  in 
a  tube  (see  Fig.  90) . 

Fluid  extract  of  ergot  1.0  to  2.0  every  half  hour,  or 
if  the  animal  vomits  give  0.50  to  0.75  of  ergot  hypoderm- 
ically  every  half  hour. 

In  some  cases  where  the  bitch  is  observed  by  the 
veterinarian,  it  is  well  to  irritate  the  vagina  and  uterus 
between  the  birth  of  each  puppy,  and  particularly  so 
after  the  animal  has  delivered  the  last  foetus;  the  best 
solution  is  a  mild  solution  of  corrosive  sublimate  1  to 
3000,  or  boracic  acid  solution.  "When  the  foetus  is  dead 
and  the  membranes  are  commencing  putrefaction,  the 
constant  application  of  antiseptics  must  be  made  until 
either  the  foetus  and  memln-ane  are  expelled  or  removed  surgically. 

When  the  foetus  is  in  an  irregular  position,  and  after  failing  to  remove 
it  by  means  of  forceps,  finger,  loop,  etc.,  or  if  the  foetus  is  so  very  large 
that  it  is  impossible  to  get  it  through  the  pelvic  opening,  or  if  it  cannot  be 
reached,  so  that  it  can  be  cut  into  sections,  or  if  the  pelvis  is  contracted, 
due  to  permanent  cicatricial  contractions,  or  a  tumor  present  in  the 
uterus  or  vagina,  we  must  perform  the  Caesarean  section. 

Caesarean  Section,  Hysterotomy,  Secto  Caesarea. — This  is  a  very 
dangerous  operation.  To  have  any  chance  of  success  the  operations 
should  be  performed  before  the  animal  is  in  a  state  of  collapse,  or  the 
foetus  is  dead   and   commencing  to  decay,  or  the  temperature  has  not 


Fig.   S9. — Retrac- 
tors, single  and 
double. 


OBSTETRICS 


221 


risen  much  above  normal.  Empty  the  bladder  and  the  lower  bowel;  and 
having  washed  out  the  genital  passages  with  an  antiseptic  solution,  put 
the  animal  under  ether.  The  bitch  is  laid  on  her  back,  the  legs  are  held 
by  an  assistant,  the  forelegs  together  and  the  hind  legs  wide  apart.  The 
region  where  the  incision  is  to  be  made  should  be  thoroughly  washed  and 
the  hair  removed  from  the  part.  Make  an  incision  on  the  median  line  of 
the  linea  alba  anterior  to  the  umbilicus  with  a  sharp-pointed  bistoury, 
and  cut  into  the  abdominal  cavity,  taking  care  not  to  injure  the  intestines 
or  uterus;  then  insert  a  probe-pointed  bistoury  and  make  the  opening 


Fig.  90. — Apparatus  for  the  extraction  of  the  foetus  and  method  of  extraction:  a,  Brulet's  apparatus; 
b,  method  of  application.;  c,  Defay's  apparatus. 

larger,  cutting  toward  the  pubis;  then  cut  through  the  omentum;  the 
uterus  is  now  visible  and  can  be  lifted  out  and  the  foetuses  can  be  felt  in 
the  uterus,  separated  by  a  constriction  of  the  body  of  the  horn.  Pull  the 
uterus  out  of  the  opening  as  far  as  possible  and  have  an  assistant  keep  the 
opening  of  the  abdominal  wall  closed,  so  as  not  to  allow  the  intestines  to 
escape,  and  also  to  avoid  any  of  the  fluids  from  the  uterus  falling  into  the 
cavity;  and  by  means  of  a  bistoury  open  the  uterus  by  making  an  incision 
through  its  wall;  the  opening  should  not  be  any  larger  than  is  necessary  to 
get  the  foetus  and  the  membranes  out.  It  is  not  necessary  to  make  an 
incision  in  the  horn  over  each  foetus,  but  after  one  foetus  is  removed  the 
others  can  be  pushed  toward  the  opening  and  removed  through  it,  taking 
care  to  remove  the  membranes  also.  The  uterus  is  now  thoroughly  dis- 
infected with  corrosive  sublimate  solution  (1  to  5000)  or  boric  acid,  2  per 


222      DISEASES  OF  THE  URINARY  AND  SEXUAL  APPARATUS 

cent.,  or  creolin;  and  close  the  incision  by  means  of  a  Laml)erts'  suture 
(using  the  stitch  illustrated  in  Fig.  20,  page  70),  using  catgut  ligature. 
If  the  other  horn  of  the  uterus  contains  fcetus,  it  must  be  treated  in  a 
similar  manner,  irrigated  and  closed,  then  sew  up  the  abdominal  muscles 
by  an  interrupted  suture,  using  silk.  The  abdomen  is  covered  with  a 
piece  of  absorbent  cotton  soaked  in  a  mild  solution  of  corrosive  sublimate 
and  held  in  position  by  an  eight-tailed  bandage  of  muslin  tied  over  the 
back.  This  has  to  be  dressed  daily.  The  animal  must  have  absolute  rest 
and  be  fed  on  food  that  is  easily  digested  and  not  apt  to  constipate  or 
ferment.  Meat  juice  or  extract  is  the  best;  vegetables  are  contraindicated. 
Removal  of  the  Uterus,  Hysterectomy. — This  operation  is  performed 
in  inguinal  hernia  of  the  l)itch,  with  strangulation,  in  uterine  tumors, 
and  chronic  catarrh  of  the  uterus,  and  when  after  the  abdomen  is 
opened  as  in  tlie  operation  just  described  and  it  is  found  that  the 
uterus  is  either  lacerated,  necrosed  or  that  the  uterus  is  in  such  condi- 
tion that  if  it  is  not  removed  it  will  endanger  the  life  of  the  animal. 
Open  the  abdomen  on  the  linea  alba  or  the  flank,  the  former  is  much  more 
satisfactory  and  to  be  preferred,  and  the  uterus  is  brought  down  out  of 
the  opening,  and  a  douljle  ligature  is  put  on  the  horn  close  to  the  ovary, 
or,  better  still,  remove  the  ovary,  then  a  double  ligature  is  put  on  the  uterus, 
close  to  the  vagina.  When  the  uterus  is  filled  with  foetus,  it  is  best  to 
empty  the  uterus,  taking  care  not  to  allow  the  escaping  fluids  to  flow  into 
the  abdominal  cavity;  the  ligated  horn  and  uterus  are  cut  between  the 
doul)le  ligatures,  and  the  broad  ligament  separated,  and  it  is  wise  to 
apply  the  thermo-cautery  to  the  stumps  of  the  horn  and  the  uterus,  then 
close  the  abdominal  wound,  bandage  the  abdomen  and  treat  the  animal 
as  in  any  grave  surgical  case. 

Irregularities  of  Sexual  Instinct. 

Absence  or  Loss  of  Sexual  Desire. — This  condition  may  result  from 
a  variety  of  causes:  (1)  general  debility,  (2)  ana?mia,  (3)  irregular  or 
improper  food,  (4)  phlegma,  especially  in  over-fed  animals,  (5)  too  fre- 
ciuent  sexual  intercourse,  as  dogs  in  the  stud,  that  have  suddenly  become 
popular  and  have  a  great  number  of  bitches  sent  to  them,  (G)  onanism, 
where  animals  have  no  intercourse,  and  learn  to  masturbate  on  objects 
slightly  elevated  from  the  ground,  a  rung  of  a  chair,  the  shaft  of  a  wagon, 
and  in  the  kitchens  of  families,  where  small  pet  animals  are  kept,  the 
servant  maids  hold  vip  their  foot  and  encourage  the  dog  to  masturbate 
on  that  until  they  are  exhausted,  (7)  from  disease  of  the  spine  or  of  the 
genital  organs.  In  the  l^itch  sterility  may  result  from  catarrh  of  the 
uterus  or  vagina,  causing  a  discharge  of  acid  mucus,  that  destroys  the 
spermatozoa.     In  certain  male  dogs  they  become  so  violently  excited 


CASTRATION  OF  THE  BITCH  223 

that  the}'  arc  unable  to  perform  the  act  properly,  or  there  may  be  partial 
loss  of  erectile  power  in  the  corpus  cavernosum  and  the  dog  does  not  hold 
long  enough,  for  the  sperm  to  be  secreted  and  it  is  ejaculated  after  they 
separate. 

Therapeutics. — If  there  are  any  pathological  alterations  they  should 
either  be  alleviated  or  the  case  may  be  such  as  to  be  impossible  to  alle- 
viate, or  we  may  administer  an  aphrodisiac  to  the  animal  for  some  time 
previous  to  the  time  the  animal  is  to  serve  the  bitch.  Tincture  of  can- 
tharides  2  to  10  drops  once  or  twice  daily  in  wine  or  barley  water  or  hydro- 
chlorate  of  yohimbin  two  or  three  times  daily,  a  fourth  to  a  half  tablet 
which  contains  0.01  in  solution  of  acacia.  In  the  bitch  yohimbin  should 
be  administered  for  five  days  and  then  the  bitch  is  put  with  another  bitch 
in  heat,  this  as  a  rule,  produces  sexual  excitement  in  ten  days.  If  ster- 
ility is  due  to  acidity  of  the  secretion  of  the  vaginal  mucous  membrane, 
irrigations  of  alkalines  are  advised  such  as  carbonate  of  soda,  1  per  cent, 
bicarbonate  of  soda  2  to  '3  per  cent. 

Excessive  Venereal  Excitement.  Satyriasis  and  Nymphomania. — 
This  may  occur  as  a  result  of  certain  diseases  of  the  genital  organs,  but 
frequently  occurs  in  the  male,  from  unknown  causes,  (see  also  priapismus). 
Venereal  excitement  is  a  common  thing  in  male  dogs,  their  actions,  in 
play  or  in  excitement  all  tend  toward  stimulation  of  the  sexual  act,  and 
frequently  dogs  learn  to  practice  onanism,  gradually  becoming  emaciated, 
accompanied  by  dulness  of  the  senses,  weakness  or  loss  of  sexual  power, 
and  frequently,  partial  or  complete  paralysis. 

Therapeutics. — If  the  venereal  excitement  is  not  due  to  any  patho- 
logical alteration  of  the  genital  organs,  the  animal  should  be  kept  on  low 
diet,  very  little  meat,  and  the  administration  of  saline  laxatives,  and  the 
salts  of  bromide  of  soda  or  potassium,  and  if  these  methods  fail,  resort  to 
castration. 

Castration  of  the  Bitch  {Ovariotomy). 

This  operation  is  generally  performed  to  avoid  the  trouble  that 
owners  have  when  a  bitch  is  in  "  heat,"  and  also  tends  to  make  them  good 
quiet  house  clogs.  The  operation  is  a  very  simple  one  and  not  attended 
by  any  great  danger  if  the  proper  antiseptic  rules  are  followed,  provided 
the  animal  is  not  too  fat,  pregnant  or  in  ''heat"  at  the  time  of  operation, 
or  there  are  no  tumors  of  the  ovaries,  that  by  either  greatly  increasing  the 
size  of  the  ovary  or  adhering  to  the  adjacent  tissues  interfere  with  their 
removal.  Xormally  the  ovaries  are  small,  elongated,  somewhat  irregular 
bodies  about  the  size  of  a  small  bean,  lying  posterior  to  the  kidney  and 
cncapsuled  in  a  pouch  and  generally  surrounded  by  fat.  The  operation  is 
either  performed  through  the  flank  or  on  the  linea  alba,  while  the  animal  is 


224      DISEASES  OF  THE  URIXARY  AND  SEXUAL  APPARATUS 

either  narcotized  with  morphia  or  ana?sthotizecl  with  ether.  Before  operat- 
ing the  animal  shoukl  have  food  withheld  for  twenty-four  hours,  and  the 
region  of  the  incision  carefully  prepared,  first  by  shaving  all  hair  in  the 
immediate  region,  and  then  carefully  disinfecting  it. 

Operation  on  the  Linea  Alba. — The  bitch  is  given  a  narcotic,  or  ether- 
ized, or  both,  and  placed  on  a  table  on  her  back  and  an  incision  made 
in  the  linea  alba  at  the  umbilicus,  with  a  sharp-pointed  bistoury,  and 
then  the  opening  is  enlarged  by  means  of  a  probe-pointed  bistoury,  cutting 
toward  the  diaphragm,  the  size  of  the  opening  is  just  large  enough  to 
freely  admit  the  index  finger.  Some  operators  introduce  a  sound  into 
the  uterus  previous  to  the  operation,  but  this  as  a  rule,  is  unnecessary,  as 
familiarity  with  anatomy,  will  easily  detect  the  difference  Isetween  intes- 
tine and  the  fallopian  tubes.  The  finger  is  introduced  into  the  abdomen 
close  against  the  wall  and  the  horn  of  the  uterus  is  felt,  the  end  of  the 
finger  is  hooked  under  it  and  drawn  toward  the  opening,  and  by  careful 
traction,  the  ovary  is  drawn  toward  the  opening  and  cut  ofT  with  the 
scissors;  sometimes  it  is  necessary  to  tear  the  ovary  from  its  attachments 
to  get  it  to  the  surface.  The  same  procedure  is  followed  in  the  other 
ovary  and  the  wound  closed  with  an  interrupted  silk  stitch. 

Many  operators  perform  castration  in  very  young  and  even  in  older 
dogs,  by  opening  the  abdominal  cavity  at  the  linea  alba  and  ligating  the 
uterus  by  two  catgut  ligatures  about  an  inch  apart  on  the  body  of  the 
uterus,  and  cut  through  between  the  ligatures.  This  method  has  the 
advantage  of  being  very  simple,  and  there  is  little  or  no  danger  connected 
with  it,  but  the  writer  has  tried  a  number  of  cases  for  experiment  and 
found  in  a  short  time  a  great  collection  of  creamlike  matter,  gathered  at 
the  ligated  end  of  the  uterus  toward  the  ovary,  and  distended  that  portion 
very  much,  which  was  noticeable  by  an  enlargement  of  the  abdomen. 
This  result  can  be  prevented  to  a  great  extent,  by  ligating  and  cutting  each 
horn  separately,  and  as  high  and  near  the  uterus  as  possible.  This  compli- 
cates the  operation,  and  as  the  prime  ol;)ject  of  the  operation  is  to  pre- 
vent the  recurrence  of  the  periods  of  ''heat,"  as  the  ovary  is  not  removed 
•  by  this  mode  of  operating  the  phenomenon  recurs  at  the  regular  periods 
and  while  it  is  true  it  is  impossible  for  the  animal  to  become  pregnant, 
it  still  is  not  an  operation  to  be  desired. 

Castration  by  Flank  Operation. — Many  operators  advise  castration 
through  the  flank,  and  jM'ocecd  in  the  following  manner:  Make  an  inci- 
sion in  the  flank  about  4  cm.  long,  midway  between  the  last  false  rib  and 
the  thigh  and  the  transverse  process  of  the  vertebra,  in  an  anterior  direc- 
tion, cutting  through  the  skin  and  muscular  layer;  then  tear  the  peri- 
toneum by  means  of  the  finger  or  knife,  or  lifting  the  peritoneum  by 
means  of  a  pair  of  forceps,  cut  it  through  with  a  scissors,  then  the  index 
finger  is   introduced   into   the   abdominal  cavity,  the  fallopian   tube  is 


MAMMITIS   MASTITIS  225 

found,  hooked  with  the  finger  the  ovary  is  pulled  down  to  the  opening 
and  cut  off  either  by  scissors  or  twisted  off  with  forceps,  care  being  taken 
to  remove  the  ovary  entirely.  Some  authors  recommend  removing  a 
portion  of  the  horn  with  the  ovary;  this,  however,  is  not  really  necessary. 
After  removing  the  ovary,  the  Fallopian  tube  is  traced  back  to 
the  bifurcation  at  the  uterus,  the  other  tube  found  and  followed  back  to 
the  other  ovary,  which  is  removed  in  the  same  manner.  In  cases  where 
the  remaining  ovary  cannot  be  reached,  laparotomy  is  made  on  the  other 
flank,  and  the  ovaries  pulled  through  the  opening  and  then  cut  off  with 
the  scissors,  and  the  wound  sewed  up  as  described  in  the  other  operation. 
Friedberger  has  operated  on  hundreds  of  bitches  in  the  above-described 
manner;  he  removes  both  ovaries  through  the  one  opening  in  the  left 
flank.  Gunther  makes  an  opening  in  both  flanks,  taking  one  ovary  out 
of  each.  The  subsequent  treatment  consists  of  feeding  the  animal  on 
small  quantities  of  easily  digested  food,  and  treating  the  wound  with  the 
regular  antiseptics. 

DISEASES  OF  THE  MAMMARY  GLAND. 

INFLAMMATION  OF  THE  MAMMARY  GLAND. 

MAMMITIS.     MASTITIS. 

True  inflammation  of  the  mammary  gland,  due  to  bacterial  infec- 
tion is  extremely  rare.  It  may  occur,  however,  in  an  acute  or  chronic 
state  as  a  result  of  traumatisms,  kicks,  blows,  cuts,  orinjuries  incident  to 
suckling  puppies,  or  congestion  of  the  udder  from  caking  or  drying  of  the 
milk,  and  consequently  retention  and  tumefaction,  and  finally,  the  for- 
mation of  abscess  of  the  gland.  This  condition  may  be  caused  by  sudden 
removal  of  the  puppies,  or  the  pups  born  dead  and  the  udder  filled  with 
milk. 

The  udder  may  be  swollen  through  its  entire  length  or  certain  sec- 
tions may  be  affected.  It  is  warm  and  painful  to  the  touch,  the  affected 
part  is  deep  red  or  in  white  animals,  purple  red,  and  the  swelling  cede- 
matous.  Pressure  on  the  nipple  causes  the  milk  to  flow,  and  it  is  thin,  gray- 
ish white,  sometimes  very  thick  and  creamy,  the  latter  generally  containing 
pus  or  is  streaked  with  blood.  In  more  acute  cases,  there  is  fever,  loss  of 
appetite,  the  tissues  become  purple  red  and  it  forms  an  abscess,  which 
fluctuates,  points  and  allows  the  escape  of  creamy  pus,  streaked  with 
blood;  it  may  in  some  cases  become  gangrenous  and  a  portion  slough  out, 
and  in  rare  cases  cause  death.  Occasionally  cases  become  chronic  and 
certain  portions  of  the  gland  atrophy,  or  become  corded  or  nodulated. 

Treatment. — The  puppies  must  be  removed  as  soon  as  possible,  the 
gland  bathed  frequently  with  warm  water  and  lead  water  solution  applied, 
15 


226      DISEASES  OF  THE  URINARY  AND  SEXUAL  APPARATUS 

or  an  ointment  of  extract  of  belladonna,  0.05  lanoline  3 . 0.  This  is  to  be 
rubbed  in  or  if  the  abscess  is  commencing  to  form  pus,  apply  poultices  or 
hot-water  cloths,  by  means  of  the  Priessnitz  compress;  when  the  abscess 
forms  pus  open  freely.  The  resulting  hardening  of  the  gland  after  an 
acute  attack  of  inflammation  maybe  removed  by  the  application  of  iodine 
painted  on  once  daily  for  several  days,  then  apply  an  ointment  of 
iodide  of  potassium  in  lanolin  one  to  twenty.  This  is  to  be  rubbed  in  and 
daily  massaging  of  the  gland  is  recommended.  If  the  gland  is  swollen 
and  hard  from  loss  of  puppies,  or  if  one  gland  is  not  emptied  by  the  pups, 
rubbing  with  camphorated  oil,  or  an  ointment  consisting  of  belladonna 
extract  one  part  and  lanolin  fifteen  parts,  with  low  diet,  and  mild  saline 
laxatives.  The  gland  may  be  milked  slightly,  this  procedure  must  be 
done  very  carefully,  and  then  only  when  absolutely  necessary,  as  it  is  not 
advisable  to  stimulate  the  secretion  of  milk.  Bitches  that  are  not  preg- 
nant frequently  have  a  swelling  and  enlargement  of  the  udder,  six  to  eight 
weeks  after  the  "heat"  is  over.  This  invariably  disappears  without  any 
treatment  and  it  is  not  necessary  to  treat  it  in  any  way,  but  in  very  rare 
cases,  if  the  udder  should  become  congested,  it  is  to  be  treated  as  if 
it  were  a  case  of  congestion  of  the  gland.  Very  rare  cases  have  been 
known  where  bitches  suck  the  nipples  and  stimulate  the  milk,  a  haint 
that  is  impossible  to  control,  except  by  putting  on  a  spiked  muzzle,  or 
getting  the  bitch  pregnant  will  sometimes  overcome  the  habit. 


Neoformations  of  the  Mammary  Gland. 

Various  tumors  and  enlargements  form  in  the  mammary  gland,  such 
as  fibroma,  lipoma,  chondroma,  osteoma,  adenoma,  myxoma,  sarcoma 


Fig.  91. — Tumor  of  the  mammary  gland. 


and    carcinoma,  and  frequently  mixed  tumors,  such  as  adenosarcomas 
fibrochondromas,  fibrosarcoma,   chondrosarcoma,  etc.,   and    there  may 


NEOFORMATIONS  OF   THE  MAMMARY  GLAXD  227 

also  be  cyst  formations.  Some  of  these  mammary  tumors  reach  enor- 
mous sizes,  hang  down  and  sometimes  touch  the  ground,  (Fig.  91).  As 
a  rule  these  tumors  are  round;  flat  tumors  as  a  rule,  are  rare,  these  tumors 
may  be  round  or  apple-like  externally  or  they  may  be  nodulated  and 
irregular  and  fluctuate  at  certain  parts  of  the  tumor.  These  fluctuating 
portions  may  or  may  not  open,  and  discharge  their  contents  and  form  an 
ugly,  raw,  unhealthy  cancerous  ulcer,  which  is  constantly  licked  by  the 
animal  and  generally  we  find  enlarged  infected  lymphangitis  in  the  sur- 
rounding tissues.  Carcinoma  is  frequently  found  on  bitches  that  are 
beyond  middle  age,  in  the  form  of  carcinoma  fibrosum,  or  carcinoma 
schirrosum,  or  partially  as  carcinoma  medullare  or  myxomotodes  and 
calcification,  or  ossification,  as  well  as  cyst  formations. 

Treatment. — These  must  be  operated  on  when  the  tumor  is  well  de- 
fined, they  can  be  operated  on  and  removed  with  comparative  ease. 
When  the  tumor  infects  the  interior  of  the  gland  and  is  malignant,  the 
entire  gland  should  be  removed,  and  also  any  infected  lymphatics. 
Frohner  found  that  some  of  the  tumors  (carcinoma)  become  calcareous 
and  unless  they  are  very  large  are  best  left  alone.  Small  benign  tumors 
should  not  be  interfered  with  if  they  are  not  growing. 


DISEASES  OF  THE  NERVOUS   SYSTEM. 

EXAMINATION  OF  THE  NERVOUS  SYSTEM. 

Disturbances  of  the  nervous  system  are  marked  by  impairment  of 
consciousness,  sensitiveness,  and  motility.  Besides  these,  there  are 
complications  in  the  functions  of  the  eyes,  ears,  taste  and  smell,  and  also 
the  digestive  system. 

1.  The  Disturbances  of  consciousness  are  variously  defined  according 
to  their  intensity.  Dulness  (indifference  to  any  external  influences), 
somnolence  (drowsiness,  sleepiness,  when  the  patient  is  awakened  easily), 
stupor  (deep  sleep,  with  difficulty  in  arousing  the  patient),  coma  (entire 
unconsciousness,  where  the  animal  is  not  disturbed  by  external  influences) . 
In  extreme  cases  of  unconsciousness,  all  sphincters  of  the  body  become 
relaxed.  Such  cases  are  found  in  the  various  diseases  of  the  brain  and 
its  coverings  and  in  cases  of  injury  and  concussions  of  the  brain;  it  is  also 
seen  in  poisoning  by  narcotics,  in  uraemia,  in  acute  anaemia,  and  in  all 
diseases  accompanied  by  intense  fever  and  pain.  Short  attacks  of  un- 
consciousness may  occur  in  the  form  of  dizziness,  and  are  seen  occasion- 
ally as  the  result  of  great  excitement  or  pain  (in  operations) ;  and  also 
idiotism,  which  occurs  in  rare  instances  as  a  result  of  distemper,  when  it 
assumes  the  nervous  form. 

2. .  Disturbance  of  Sensitiveness. — This  is  not  easily  recognized  in 
the  dog.  In  all  instances  it  is  advisable  to  cover  the  patient's  eyes,  and 
compare  the  sensitiveness  of  the  affected  side  with  that  of  the  healthy  one. 
In  cases  of  haemaphraic  diseases,  we  test  the  sensitiveness  of  the  skin  by 
pricking  it  slightly  with  a  needle  or  letting  cold  water  drop  upon  it,  so  as  to 
produce  some  irritation  or  symptom  of  pain.  A  test  may  also  be  made 
by  means  of  a  battery;  still  this  method  is  not  as  reliable  and  practical  as 
the  needle  and  cold-water  test. 

Total  anaesthesia  occurs,  as  a  rule,  from  poisoning,  and  must  not  be 
mistaken  for  a  want  of  reaction,  when  in  a  comatose  condition.  Local 
anaesthesia — that  is  to  say,  a  more  or  less  circumscribed  or  disturl)ed 
zone  of  sensibility — may  be  found  in  any  part  of  the  body.  In  such  a 
case,  if  anaesthesia  corresponds  with  a  region  of  a  special  nerve  or  mixed 
nerve,  or  if  it  is  extended  over  several  nervous  regions,  or  if  it  is 
even  double-sided,  we  can  distinguish  it  as  peripheric  amesthesia.  Periph- 
eric anaesthesia  indicates  an  injury  of  the  terminal  ends  of  the  sensitive 
nerves  and  originates  through  local  influences,  intense  cold,  acids  (es- 

228 


EXAMINATION  OF  THE  NERVOUS  SYSTEM  229 

pecially  carbolic),  also  alcohol  and  certain  narcotics  (especially  cocaine). 
Peripheric  aniPsthesia  may  be  caused  by  some  traumatism,  compression, 
malformation,  or  inflammatory  exudates;  also  through  inflammations, 
such  as  degenerating  process,  etc.,  of  the  peripheric  nerves.  Spinal 
anaesthesia  is  seen  and,  as  a  rule,  is  double-sided;  due  to  compression  of 
the  nerve  or  the  spinal  cord.  Cases  of  cerebral  ansesthcsia  are  caused  by 
hemorrhages,  tumors,  inflammations,  etc.,  in  the  zone  of  the  sensitive 
nerves.  It  may  also  be  caused  by  the  effects  of  various  poisons — chloro- 
form, ether,  alcohol,  morphia,  or  bromine. 

Hyperaesthesia. — This  is  an  increased  sensitiveness  of  the  cutaneous 
nerves,  and  is,  as  a  rule,  found  in  the  early  stages  of  certain  diseases  of  the 
spinal  cord.  It  is  very  rarely  seen  in  the  later  stages  of  such  diseases.  In 
rabies  it  is  indicated  by  gnawing  of  certain  portions  of  the  body,  and  in 
neuritis  and  secondary  paralysis. 

3.  Disturbances  of  motility  appear  in  paralysis  and  convulsions  of 
the  affected  muscular  system. 

Paralysis. — We  generally  make  a  distinction  between  paralysis 
and  lameness,  that  is  to  say,  an  entire  loss  of  movement,  and  paresis  or 
weakness,  which  is  simply  due  to  debility.  In  the  first  ease  there  is  not 
the  slightest  movement  performed  in  a  muscle  or  a  whole  group  of  muscles. 
In  some  cases,  there  are  slight  muscular  movements,  but  they  are  weak, 
wit  hout  strength,  and  do  not  last  very  long.  In  order  to  determine  the  origin 
of  paralysis,  it  is  necessary  to  have  some  knowledge  of  the  psychomotor 
centres.  These  centres  are  located  in  the  cerebrum,  and  are  called  the 
cortico-muscular  leading  tracts.  Up  to  the  present  time  they  have 
definitely  located  the  following  motor  centres  in  the  external  surface  of 
the  cerebrum,  the  position  of  which  is  indicated  in  figure  92: 1  is  the  centre 
for  the  movements  of  the  muscles  of  the  neck;  2  is  that  of  the  extensors 
and  adductors  of  the  anterior  limb;  3  is  for  extending  and  turning  the 
anterior  limbs;  4  controls  the  movement  of  the  posterior  limbs;  5,  the 
facial  muscles;  and  6,  the  lateral  movement  of  the  tail;  7,  for  the  re- 
traction and  adduction  of  the  anterior  limbs;  8,  for  elevating  the  shoulders 
and  stretching  the  front  legs  (walking) ;  9,  for  dilating  and  contracting  the 
orbicularis  palpebrarum  and  zygomaticus  muscles.  In  the  front  of  9  we 
also  find  the  centre  for  the  movements  of  the  tongue.  Between  the 
anterior  and  middle  portion  of  9  is  for  closing  the  jaw.  On  irritating 
9  we  have  a  retraction  and  elevation  of  the  corners  of  the  mouth.  By 
irritating  6  the  mouth  is  opened  and  the  tongue  is  moved.  c,c  causes  a 
retraction  of  the  corners  of  the  mouth;  c  lifts  the  corners  of  the  mouth 
and  half  of  the  facial  muscles  as  far  as  the  closing  point  of  the  eyelids. 
The  middle  e  (on  irritation)  opens  the  eye  and  dilates  the  pupil. 

Any  disease  which  becomes  located  in  any  portion  of  this  cortico- 
muscular  brain  centre  and  inflames  or  stops  the  power  of  these  centres 


230  DISEASES  OF  THE  NERVOUS  SYSTEM 

must  lead  to  paralysis  of  the  centre  which  it  controls.  "VVe  therefore  can 
locate  any  disturbance  in  the  motor  centres  of  the  brain  by  the  paralysis 
which  occurs  in  certain  parts  of  the  body.  A  diseased  condition  of  the 
covering  of  the  brain,  if  not  very  extensive,  generally  causes  the  paralysis 
of  one  part  of  the  body,  as  the  single  motor  centres  are  separated  and 
very  distinct  from  one  another.  Diseases  of  the  brain,  when  they  occur 
in  the  inner  surface  between  the  capsules  and  the  pyramids,  where  all 
the  motor  fibres  are  close  together,  cause  a  more  or  less  complete  paralysis 
of  one  side  of  the  body.  That  is  to  say,  a  hemiplegia  (affecting  one  side 
of  the  brain)  causes  the  paralysis  of  the  muscles  of  the  other  side  of  the 
body.  For  instance,  if  the  disease  is  located  on  the  left  side  of  the  brain, 
the  muscles  of  the  right  side  become  paralyzed.  In  diseases  of  the  spinal 
cord  the  muscles  affected  are  on  the  same  side,  except  in  the  case  of 
diseases  of  the  cervical  portion  of  the  spine,  when,  as  a  rule,  paralysis  is 
seen  in  all  the  extremities,  and  in  disease  of  the  lumbar  region  paralysis 
of  the  posterior  extremities  is  seen.  We  therefore  summarize  in  a  general 
way  that  hemiplegia  is  usually  a  form  of  cerebral  paralysis  (of  the  con- 
trolling centres);  paraplegia  indicates  a  diseased  condition  of  the  spine; 
and  monoplegia  is  due  to  a  paralysis  of  the  brain  as  well  as  the  spine. 
This  description  gives  only  the  fundamental  theories  on  this  subject. 
Concerning  more  precise  details  we  would  direct  our  readers  to  some  one 
of  the  various  physiological  text-books. 

The  most  important  peripheric  paralyses  which  have  been  observed 
in  the  dog  (by  traumatism,  compression,  or  exudation,  inflammatory  or 
degenerating  processes  of  the  affected  nerves)  are  as  follows: 

1.  Motor  Trigeminal  Paralysis.  (Paralysis  of  the  lower  jaw.) — 
The  lower  jaw  hangs  down;  mastication  is  impossible;  saliva  runs  out 
of  the  mouth.  This  condition  occurs  very  frequently  as  a  symptom  of 
rabies.  In  rare  instances  it  has  been  observed  as  a  result  of  some  other 
disease. 

2.  Paralysis  of  the  Anterior  Limhs. — The  front  legs  hang  inert  and 
all  the  joints  flex  very  easily. 

3.  Paralysis  of  the  Posterior  Limbs. — The  hind  legs  are  dragged  along 
the  ground,  the  paws  being  flexed  and  drawn  backward.  If  the  paws 
are  drawn  forward  and  this  flexion  overcome,  the  animal  is  able  to  stand 
on  its  legs  if  the  body  is  held. 

4.  Paralysis  of  the  Cruralis. — In  this  condition  the  animal  does  not 
use  the  posterior  limb.  All  the  joints  become  flexed  abnormally,  and 
the  thigh  bends  backward.  This  condition  may  also  be  due  to  some 
disease  of  the  spine. 

The  electrical  current  is  very  useful  to  determine  how  much  certain 
muscles  and  nerves  can  be  excited  by  the  current  and  is  particularly 
useful  in  the  diagnosis  of  paralysis  of  the  nerves  and  muscles  and  nutritive 


EXAMINATION  OF  THE  NERVOUS  SYSTEM 


231 


Fig.  92. — /.,  shows  superior  portion  of  the  cerebrum;  II.,  the  lateral  surface;  and  /.,  //.,  ///.,  IV. 
are  the  four  convolutions.;  .S',  is  the  sulcus  cruciatus;  F,  the  fissure  of  Sylvius;  o,  the  bulbus  olfactorius; 
p,  is  the  optic  nerve.  The  motor  centres  are;  1,  for  the  muscles  of  the  neck;  2,  for  the  extensors  and 
adductors  of  the  anterior  limbs;  3,  for  the  flexors  and  rotators  of  the  anterior  limb;  4,  for  the  muscles 
of  the  posterior  Umbs;  5,  for  the  facial  muscles;  6,  for  the  lateral  movements  of  the  tail;  7,  for  the  re- 
traction and  adduction  of  the  anterior  limbs;  8,  for  the  lifting  of  the  shoulder  and  extension  of  the  front 
limb  (walking);  9,  9,  for  the  orbicularis  palpebrarum,  zygomaticus,  and  closing  of  the  eyelid;  /.,  t,  the 
heat-centre  of  Eulenberg  and  Landois.     (Landois.) 

Fig.  92. — //.,  a,  a,  retraction  and  elevation  of  the  corners  of  the  mouth;  b,  opening  of  the  mouth 
and  movements  of  the  tongue;  d,  the  opening  of  the  eyelids. 


232 


DISEASES  OF  THE  NERVOUS  SYSTEM 


disturbances  of  the  same.  The  faradic  or  the  open  circuit  can  be  used. 
One  electrode  is  placed  on  the  body,  generally  along  the  spine  and  the 
other  is  placed  on  the  muscle  to  be  stimulated.  The  first  electrode, 
that  is  placed  along  the  spine  should  be  of  large  size  and  the  other  that 
is  to  be  placed  on  any  particular  nerve  of  muscle,  must  be  comparatively 


31  3^    33  3*3^ 


Fig.  93. — Motor  centre  points  of  the  clog  (after  Nahrich):  1,  caninus  muscle;  2,  levator;  labii  super- 
ioris;  3,  orbicularis  oris;  4,  levator  naso  labialis;  5,  currugator  supercilii  and  orbicularis  palpebrarum; 
6,  corrugator  supercilii  and  orbicularis  palpebrarum;  7,  orbiculo-palpebralis  nerve;  8,  masseter;  9, 
zygomaticus  muscle;  10,  superior  lateral  retractor  of  the  ear;  11,  sterno-hyoideus;  12,  sterno-cephalicus; 
13,  trapezius;  14,  omotransversarius;  15,  cleidocervicalis;  16,  thoracic  portion  of  the  trapezius; 
17,  scapular  portion  of  the  deltoid;  18,  axillary  nerve;  19,  acromian  part  of  the  deltoideus;  20,  anconeus 
longus;  21,  anconeus  lateralis;  22,  ramus  profundus  with  radial  nerve;  23,  extensor  digitalis  communis; 
24,  adductor  poUicis  longus;  25,  extensor  digitalis  lateralis;  26,  extensor  carj^i  ulnaris;  27,  anconeus 
brevis;  28,  cutaneus  maximus;  29,  latissimus  dorsi;  30,  obliquus  abdominalis  externus  31,  illiohy- 
pogastric  nerve;  32,  illioinguinalis;  33,  sartorius;  34,  tensor  fascia  lata;  35,  gluteus  medius  36,  gluteus 
superficialis;  37,  biceps  femoris;  38,  semitendinosus;  39  peroneus  nerve;  40,  extensor  digitalis 
lateralis;  41,  peroneus  brevis,  42,  tibial  nerve. 

small  so  as  not  to  cover  more  than  the  part  to  be  stimulated.  The 
electrode  must  be  covered  with  linen  or  woolen  cloth  and  moistened  with 
a  weak  solution  of  common  salt.  The  reflex  movements  are  prompter 
when  the  electrode  is  placed  on  the  so-calletl  motive  points  which  (Fig.  93) 
will  give  some  idea  of  their  location. 

When  a  muscle  is  in  normal  condition  it  will  answer  promptly,  when 


EXAMINATION  OF  THE  NERVOUS  SYSTEM  233 

the  electrode  is  put  on  it,  by  a  quick  quiver.  In  a  degenerated  or  atrophied 
muscle,  the  reaction  is  a  slow  vermicular  cjuiver  or  in  old  cases  where 
the  paralysis  has  existed  for  a  long  time  there  may  be  no  motion  at  all. 
The  constant  or  open  current  will  frequently  stimulate  muscular  con- 
traction, when  the  faradic  current  will  give  no  movements  whatever. 
AMien  degenerative  muscular  atrophy  has  set  in  for  any  length  of  time 
no  reaction  can  be  obtained  from  either  current.  For  further  details 
see  special  work  on  this  subject. 

The  most  important  test  of  paralyzed  muscles  is  their  size.  In  all 
cases  of  prolonged  paralysis  the  muscles  atrophy  ciuickly.  The  muscle 
gradually  becomes  smaller  and  smaller  until  it  resembles  a  cord  or  tendon. 
In  cerebral  paralysis  this  does  not  occur,  while  in  spinal  paralysis  it  is 
always  present.  Of  course,  in  some  instances  an  inactive  muscle  will 
atrophy  without  any  actual  disease  being  present.  The  amount  of 
atrophy  which  may  occur  in  certain  cases  is  indicated  by  a  communication 
given  to  the  author  l^y  Goubaux.  In  this  instance  the  paralyzed  anterior 
limb  of  a  dog  weighed  103  grammes,  while  the  perfect  limb  weighed  148 
grammes. 

Convulsions. — Convulsion  of  the  controlling  muscles  is  the  very 
opposite  of  paralysis.  Convulsions  are  diseased  contractions  of  the 
muscles  which  are  independent  of  the  will.  There  are  several  varieties 
of  them.  Clonic  convulsions  are  short  muscular  contractions  that  occur 
at  intervals,  and  between  the  intervals  the  affected  portion  of  the  body 
quivers  constantly.  Tonic  convulsions  are  muscular  contractions  in 
which  the  muscle  remains  constantly  contracted.  It  may  occur  for  a 
minute  or  two,  or  may  last  several  days.  Tonic  clonic  convulsions  are 
the  medium  form  of  the  two  conditions  before  described.  A  mild  form 
of  clonic  contractions  is  noticed  in  the  original  muscular  twitchings. 
Trembling  and  shaking  convulsions,  seen  in  chill,  fear,  or  sudden  cooling 
after  being  very  warm,  epileptiform  convulsions,  or  eclamptic  convul- 
sions, are  seen  and  extend  over  the  whole  body.  In  very  rare  instances 
they  may  be  restricted  to  one  portion,  such  as  the  head  or  neck.  These 
generally  come  on  suddenly  and  disappear  in  a  few  minutes.  They 
are  generally  seen  in  the  early  stages  of  distemper,  in  teething,  in 
irritated  conditions  of  the  bowels,  or  from  noxious  and  poisonous  food 
and  from  parasites;  in  cases  of  pentastomum  in  the  nasal  cavities,  in 
encephalitis,  meningitis,  or  uremia,  and  occasionally  in  acute  ansemia; 
they  also  occur  from  some  injury  or  irritation  of  the  peripheric  centres, 
and  are  very  prominent  in  epilepsy.  Rhythmic  twitchings  are  seen  in 
some  muscular  regions  where  the  afTected  part  of  the  body  makes  regular 
motions;  for  instance,  in  the  muscles  of  mastication,  in  the  muscles  of 
the  chest  during  sleep,  and  also  in  the  twitching  of  certain  limbs.  They 
are  very  often  mistaken  for  chorea,  and  appear  as  a  result  of  distemper 


234  DISEASES  OF  THE  NERVOUS  SYSTEM 

or  some  disease  of  the  I)rain.  They  may  also  occur  from  disorder  of  the 
spine.  These  so-called  cataleptic  attacks  consist  of  a  rigid  and  contracted 
condition  of  all  the  muscles  of  the  body,  but  are  subject  to  passive  move- 
ments. Nothing  is  known  concerning  their  etiology.  Tetanic  convul- 
sions are  tonic  convulsions  of  the  whole  muscular  system  of  the  body, 
They  appear  in  tetanus  and  in  some  cases  of  poisoning  (strychnine, 
brucine,  caffeine,  etc.).  A  variety  of  these  tetanic  convulsions  is  some- 
times observed  in  the  so-called  cases  of  eclampsia  in  bitches  who  are 
nursing  a  large  litter  of  puppies.  Forced  irregular  actions  of  the  body, 
such  as  walking  backward  or  in  a  circle,  or  the  animal  rotating  on  its 
own  axis,  are  seen  as  a  rule  in  diseases  of  the  cerebellum  and  in  some 
cases  of  poisoning  (cocaine).  In  rare  instances  we  see,  in  the  above 
mentioned,  symptoms  of  '' ej^ileptif orm  attacks,"  w'hich  we  will  refer  to 
further  on. 

Ataxia  is  due  to  disturbance  of  motility  or  an  interference  in  the  co- 
ordination of  muscular  action.  Animals  are  unsteady  on  their  legs, 
stagger  from  one  side  to  another,  and  their  action  in  walking  is  irregular. 
Ataxia  is  undoubtedly  found  in  some  diseases  of  the  cerebellum,  and  may 
also  be  seen  in  disease  of  the  pons  and  the  fore  ventricles,  and,  in  very  rare 
instances,  of  the  spinal  cord.  Ataxia  occurs  very  often  as  a  result  of  dis- 
temper, and  it  occurs  without  any  previous  brain  or  spinal  symptoms. 

Concerning  disturbances  of  vision,  hearing  and  the  action  of  the 
sphincters,  they  will  be  described  under  their  special  chapters. 

Disturbance  of  Reflex  Irritability. — Reflex  action  is  those  movements 
that  arc  caused  by  some  stimulus  or  irritation  that  produce  a  movement 
that  is  entirely  independent  of  the  will,  unless  the  will  is  concentrated  to 
oppose  the  movement.  In  this  instance  we  call  particular  attention  to  what 
is  known  as  patellar  reflex.  The  animal  is  laid  on  his  side  with  the  hind 
leg  to  be  examined  on  the  upper  side,  the  leg  is  slightly  flexed  and  with 
the  index  finger  or  a  percussion  hammer  a  cpick  blow  is  made  on  the 
patellar  ligament  below  the  patella;  under  normal  circumstances  the 
quadriceps  femoris  muscle  makes  a  quick  contraction,  the  muscles  of  the 
leg  contract  and  the  leg  is  sprung  forwards.  The  same  reflex  but  to  a 
lesser  extent  is  also  seen  at  the  anterior  face  of  the  carpal  articulation,  the 
Achilles  tendon,  skin  of  the  sole  of  the  foot  and  the  abdominal  wall.  An 
increase  of  the  reflex  is  seen  in  the  course  of  chronic  diseases  of  the  brain, 
in  myelitis  transversalis,  spinal  paralysis  (first  observed  by  Dexter)  pois- 
oning with  strychnia,  tetanus.  A  diminution  of  the  reflex  is  sometimes 
found  in  acute  diseases  of  the  lirain,  which  have  been  verj'  rapid  in  their 
development,  in  certain  diseases  of  the  spinal  substance,  in  disease  of  the 
peripheric  nerves  (in  which  case  it  is  confined  to  the  territory  of  the  corre- 
sponding nerve)  and  in  coma.  The  brain  reflexes  to  be  particularly  con- 
sidered are  the  conjunctival  and  corneal  reflex  seen  by  the  closure  of  the 


HYPEREMIA  OF  THE  BRAIN  235 

eyelids  on  touching  the  conjunctival  ]nill)i  or  the  cornea  and  the  puj^il 
with 'its  contraction  or  dilatation  on  the  impression  of  light. 


DISEASES  OF  THE  BRAIN  AND  ITS  COVERINGS. 
Hyperaemia  of  the  Brain. 

Etiology. — There  is  an  active  and  passive  hyperaemia.  Active  hy- 
pera?niia  of  the  brain  is  caused  by  an  increase  of  the  circulation  as  the 
result  of  increased  heart-action.  This  occurs  in  hypertrophy  of  the  left 
ventricle,  from  excitement,  in  young  animals,  from  heat  (sunstroke),  in 
great  bodily  exertion,  in  teething,  high  temperture;  blows,  nervous  tem- 
perament, from  overeating,  the  effects  of  certain  narcotics,  and  as  a 
secbndary  symptom  of  certain  diseases. 

Passive  hyperaemia  (stagnation)  occurs  in  compression  of  the  jugular 
veins  by  tumors,  such  as  large  goitres,  by  obstructed  respiration,  from 
tight  collars,  in  acute  bronchitis,  and  in  compressed  conditions  of  the  lung 
due  to  hydrothorax,  extended  indurations  of  the  lungs,  defects  in  the  ve- 
nous openings  of  the  heart.  Hypersemia  of  the  brain  accompanies  various 
acute  internal  diseases,  and  as  a  secondary  symptom  of  a  large  number  of 
disorders;  it  is  also  seen  as  a  result  of  various  poisons,  such  as  alcohol, 
certain  narcotics,  etc. 

Pathological  Anatomy. — As  a  rule,  hyperemia  of  the  brain  occurs  in 
connection  with  congestion  of  the  coverings  of  the  brain,  especially  the 
pia  mater.  When  hyperaemia  is  very  intense,  or  where  it  has  existed 
for  a  long  time,  we  cannot  definitely  separate  the  conditions.  We  find 
the  dura  mater  distended,  but  very  little  changed.  The  vessels  of  the  pia 
mater  are  much  injected,  the  torsions  of  the  vessels  are  flattened,  and  the 
sulci  are  perfectly  flat  as  if  pressed  out  of  shape.  We  find  the  gray  matter  is 
darker  than  usual,  while  the  white  brain  substance  is  dull  gray  or  yellow- 
ish red,  and  presents  numerous  bloody  spots  which  may  be  easily  removed. 
In  chronic  conditions  of  this  disease,  we  find  venous  hyperaemia.  The 
brain  appears  in  such  cases  pale  and  anaemic,  very  moist  and  soft,  and  on 
section  has  a  brilliant,  mirror-like  lustre.  It  is  lessened  in  size  and  doughy 
in  consistence  and  the  subarachnoidal  fluid  is  increased. 

Clinical  Symptoms. — The  symptoms  of  active  hyperaemia  of  the 
brain  are  characterized  by  a  sudden  development  of  excitable  symptoms. 
These  consist  in  great  restlessness,  running  around,  making  frequent 
changes  of  position,  irritability,  a  tendency  to  biting  and  attacks  of  de- 
lirium, partial  or  general  convulsions,  and  an  increased  activity  of  the  act- 
ion of  the  heart.  The  pulse  is  quick  and  irregular;  the  respirations  are 
short.  There  is  congestion  of  the  mucous  membranes  of  the  head,  and  the 
upper  portion  of  the  head  is  warm  to  the  touch.     There  is  contraction  of 


23(3  DISEASES  OF  THE  NERVOUS  SYSTEM 

the  pupils  and  sometimes  vomiting.  These  symptoms  of  excitement 
rarely  last  very  long,  and  generally  disappear  quickly;  although  in  rare 
instances,  they  may  last  some  time  without  leaving  any  trace  on  the  gen- 
eral system.  They  may,  however,  alternate  with  periods  of  apparent  rest 
to  recur  again  in  a  short  time.  The  writer  has  observed  this  in  cases  of 
apoplexy  of  the  brain.  In  this  condition  there  is  dulness,  unsteady  gait 
and  if  there  is  entire  stupor,  stertorous  respiration  is  apt  to  be  present 
with  this  last  symptom.  It  is  doubtful  in  such  cases,  if  we  have  to  deal 
with  actual  hypcrsemia;  more  likely,  a  more  of  less  serious  alteration  in 
the  brain. 

Therapeutics. — Bleeding,  as  a  rule,  is  contraindicated  on  account  of 
the  debilitated  condition  of  most  dogs  when  they  develop  hyperaemia. 
We  would,  however,  recommend  enemas  (soap  and  water)  and  purgatives 
with  quick  action,  such  as  sulphate  of  magnesium  in  large  dcses,  senna 
leaves,  or  castor  oil.  Cold  compresses  (ice  bags)  around  the  head  are  also 
useful,  while  violent  purgatives  such  as  croton  oil,  are  not  advisable,  as 
they  excite  the  animal,  produce  great  irritation  and  generally  do  more 
harm  than  good.  The  animal  should  be  put  in  a  cool  room  and  kept  as 
quiet  as  possible,  avoiding  excitement  or  heat  and  also  feed  the  animal 
very  light.  In  cases  where  marked  symptoms  show  themselves,  an 
injection  of  morphine  is  generally  indicated. 


Anaemia  of  the  Brain. 

Etiology. — The  most  common  cause  of  anaemia  of  the  brain,  is  im- 
poverished blood,  acute  hemorrhage,  prolonged  debilitating  disease,  or 
from  some  obstruction  of  the  arterial  system,  such  as  tumors,  hemor- 
rhages, or  inflammatory  exudations  within  the  skull;  also  compression  of 
the  carotid  arteries  by  emphysema,  and  in  some  instances  from  contrac- 
tion of  the  small  arteries  of  the  brain,  caused  by  excitement.  Chronic 
anaemia  of  the  brain  may  be  caused  by  the  presence  of  intercranial  tumors, 
or  hemorrhage,  chronic  hydrocephalus  pachj'^meningitis. 

Pathological  Anatomy. — The  white  substance  in  rare  instances  has  a 
few  bloody  points.  As  a  rule,  however,  the  brain  appears  on  section  dull 
white,  the  gray  matter  being  unusually  bright,  without  any  trace  of  col- 
oration. The  meninges  and  coverings  of  the  brain  may  possess  their  nor- 
mal quantity  of  blood,  even  in  intense  anaemia. 

Clinical  Symptoms. — Acute  anaemia,  especially  when  it  has  been 
caused  by  hemorrhages,  is  indicated  by  a  small,  weak  pulse,  dilatation  of 
the  pupils  and  a  coldness  of  the  extremities,  with  attacks  of  dizziness,  and 
loss  of  conciousness.  Convulsions  are  rarely  present  in  chronic  anaemia 
of  the  brain,  and  very  often  stupidit}',  (luivering  of  the  muscles,  great 


CEREBRAL  HEMORRHAGE  237 

fatifiTio  on  the  slightest  exertion,  loss  of  appetite,  and  a  tendency  to  vom- 
iting is  noticed,  and  even  general  convulsions. 

Therapeutics. — The  therapeutic  treatment  consists  in  stimulants, 
such  as  wine,  ether,  camphoi',  atropia,  caffein,  friction  to  the  skin,  smelling 
spirits  of  ammonia,  stimulation  of  the  phrenic  nerve  by  the  faradic 
battery,  etc.  In  the  chronic  form  nutritive  diet,  blood-producing  food, 
and  tonics. 


Cerebral  Hemorrhage. 

(Apoplcxia  Sanguitiijc;  Hemorrhagica  Cerebri.) 

Etiology. — The  chief  cause  of  cerebral  hemorrhage  is  an  increased 
pressure  on  the  vessels  containing  the  l)lood,  and  where  the  walls  of  these 
vessels  present  some  abnormal  condition  by  which  they  are  debilitated  or 
weakened.  This  condition  of  the  walls  of  the  vessels  may  be  caused  l^y 
atheromatous  degeneration,  or  by  some  disturbances  in  the  nutritive 
process  of  those  parts,  as  in  serious  diseases  of  an  infectious  nature,  such 
as  distemper,  leuka?mia,  and  also  in  certain  forms  of  poisoning.  Great 
exertion,  intense  physical  excitement,  or  great  heat  may  also  produce  this 
condition. 

Pathological  Anatomy. — Hemorrhages  appear,  as  a  rule,  on  the  cere- 
brum, and  occur  from  a  capillary  hemorrhage  and  are  indicated  by  a  slight 
red  coloration  which  cannot  be  wiped  off;  but  in  the  most  serious  forms 
you  may  find  a  distinct  number  of  spots  which  Ijecome  confluent.  In 
some  cases  there  is  a  considerable  bloody  discharge,  indicating  the  l)reak- 
ing  down  of  some  large  blood-vessel.  If  the  blood-vessel  is  located  in  the 
hemisphere  near  the  surface,  the  dura  mater  appears  distended  at  the 
affected  location;  the  convolutions  of  the  brain  are  flattened  and  the  fur- 
rows depressed.  The  substance  of  the  brain  is  always  more  or  less  de- 
stroyed, and,  if  the  animal  does  not  die  quickly,  the  discharged  blood  lying 
in  the  tissues  forms  clots  very  rapidly.  Its  fluid  parts  become  absorbed, 
fibrinous  substances  are  formed,  and  the  blood-corpuscles  destroyed, 
being  altered  into  a  chocolate-colored  emulsion  which  finally  becomes  ab- 
sorbed. The  coloring  matter  of  the  blood  remains  on  the  brain  as  a  rose- 
colored  pigmentation.  The  centre  becomes  smaller  and  smaller,  until  the 
development  of  numerous  connective-tissue  adhesions  unite  it  to  the 
wall,  or  an  apoplectic  cyst  is  formed,  which  has  a  smooth  inner  wall  filled 
with  serum.     This  cyst  takes  the  shape  of  the  surrounding  tissues. 

Clinical  Symptoms. — Capillary  hemorrhage  appears  occasionally  in 
some  of  the  grave  infectious  diseases,  and  may  cause  little  or  no  disturb- 
ance of  the  general  system  that  can  be  recognized  during  life,  or  there  may 
be  slight  manifestations  of  the  condition,  such  as  dizziness,  partial  loss  of 


238  DISEASES  OF  THE  NERVOUS  SYSTEM 

consciousness,  staggering  or  giddiness,  and  in  some  cases,  vomiting;  these 
however,  are  only  temporary.  In  extensive  hemorrhage,  on  the  contrary, 
there  is  the  sudden  appearance  of  grave  cerebral  symptoms.  The  animal 
falls  down  without  any  premonitory  symptoms,  or  else  shows,  for  a  short 
time,  dizziness,  staggering,  trembling  and  uncontrollable  movements, 
or  convulsions,  and  then  loses  entire  consciousness.  The  pulse  becomes 
weak  or  irregular,  or  rapid  and  very  small.  The  respirations  are  deep, 
stertorous,  and  irregular.  The  mucous  membranes  of  the  head  are  in- 
tensely reddened,  and  in  the  early  stages  of  the  attack,  convulsions  are 
very  frequently  noticed  and  involuntary  evacuation  of  urine  and  fseces. 
This  is  followed  by  partial  or  complete  paralysis,  which  is  due  partially 
to  destruction  of  the  brain  substance,  and  partially  to  the  blood  pressing  on 
the  brain.  This  paralysis  may  affect  the  extremities,  both  anterior  and 
posterior,  that  half  of  the  body  which  is  opposite  to  the  extravasation  in 
the  brain  being  the  one  affected.  The  animal  may  also  become  blind. 
This  disease  may  result:  1,  in  death,  which  occurs  either  in  a  few  mo- 
ments or  may  take  days;  2,  in  complete  recovery — this  however,  only 
occurs  where  there  is  a  small  hemorrhage,  and  in  one  of  the  centers  of 
the  hemispheres;  3,  in  complete  recovery,  with  partial  or  complete 
paralysis,  according  to  the  amount  of  hemorrhage. 

Great  hemorrhages  of  the  cerebral  membranes  are  marked  by  the 
same  symptoms  as  apoplexy  of  the  brain.  Apoplexia  meningia,  occurs 
generally  in  connection  with  violent  traumatisms  of  the  skull,  such  as 
shocks,  concussions,  fractures,  etc.  The  blood  is  generally  found  in  the 
cerebral  membrane,  between  the  dura  mater  and  the  skull.  It  may 
also  be  observed  in  the  subarachnoidal  chamber  and  in  the  brain- 
cavities.  The  symptoms  are  similar  to  those  of  apoplexy  of  the  brain, 
but,  as  a  rule,  convulsions  appear  earlier,  and  the  animal,  while  he  may 
present  symptoms  of  coma,  makes  a  much  quicker  recovery. 

Therapeutics. — Absolute  rest,  cold  compresses  on  the  head,  stimulants 
when  the  pulse  is  weak,  ether  and  camphor,  either  internally  or  subcu- 
taneousl}^  after  the  coma  disappears,  purgatives  and  injections  of  soapy 
water  per  rectum  to  stimulate  evacuations  of  the  bowels.  To  relieve 
congestion  of  blood  vessels,  administer  iodide  of  potassium. 

Traumatic  Lesion  and  Concussion  of  the  Brain. 

Concussion  and  Commotis  Cerebri. 

Etiology  and  Pathological  Anatomy. — The  cause  of  this  condition  is 
some  traumatism  to  the  skull  bcjiics,  such  as  butting  the  head  against  a 
wall  when  running  fast,  Ix'ing  hit  with  a  stone  or  quoit,  or  struck  with 
some  vehicle,  or  falling  on  the  head  out  of  a  window.     8ome  portion  of  the 


INFLAMMATION  OF  THE  BRAIN  239 

skull  is  depressed,  cracked  or  splintered,  pressing  on  the  brain  substance, 
and  causing  more  or  less  extensive  hemorrhage  of  the  interior  of  the  cavity 
of  the  brain.  The  hemorrhage  is  generally  most  extensive  in  the  dura 
mater,  between  it  and  the  cranium,  but  it  may  also  be  observed  between 
the  pia  mater  and  the  cerebral  cortex  or  even  in  the  brain  substance  itself, 
and  while  under  the  microscope  we  may  not  find  any  change  in  the  brain 
substance  in  spite  of  the  fact  that  there  is  grave  cerebral  disturbance,  it 
has  been  called  concussion  of  the  brain  and  is  due  to  a  mechanical  displace- 
ment of  the  brain  substance  and  the  fluids  of  the  brain  are  compressed  in 
the  ventricles. 

Clinical  Symptoms  and  Therapy. — Any  pronounced  traumatism  of  this 
kind  generall}'  causes  death.  There  may  be  bleeding  from  the  nose  or  ears, 
with  acute  congestion  of  the  conjunctiva.  Give  the  animal  absolute  rest, 
cold  local  applications,  surgical  treatment  of  the  injured  portion  of  the 
skull,  and  also  the  injured  soft  tissues,  evacuation  of  the  faeces  and  the 
administration  of  stimulants. 

Inflammation  of  the  Brain. 

From  a  pathological  standpoint  we  have  to  make  a  distinction  be- 
tween inflammation  of  the  hard  cerebral  substance  (pachymeningitis) 
and  that  of  the  soft  cerebral  membrane  (leptomeningitis).  This  classi- 
fication, however,  need  not  be  used  in  a  clinical  way,  because  in  the  dog, 
the  described  forms  run  their  course  with  the  same  symptoms. 

Etiology. — Inflammation  of  the  brain  may  be  the  result  of  some  trau- 
matism, or  from  sunstroke,  great  physical  excitement,  over-exertion,  etc. 
This  condition  also  occurs  secondarily  from  disease,  such  as  distemper  and 
pyaemia,  causing  suppuration  within  the  skull,  in  inflammation  of  the  frontal 
cavities  as  a  result  of  the  irritation  caused  by  the  presence  of  parasites;  in 
purulent  inflammation  of  the  ear  (in  connection  with  external  otitis), 
and  from  abscess  of  the  middle  ear  and  orbital  cavity.  Inflammation  of 
the  brain  is  seen  in  certain  infectious  diseases,  especially  distemper,  and  is 
also  associated  in  rare  instances  with  pharyngitis,  bronchitis,  gastritis, 
and  also  from  unknown  causes.  In  dogs  that  died  from  inflammation  of 
the  brain,  Trolldenier  found  a  pathogenic  streptothrix,  allied  to  the  group 
of  actinomycetes.  Over-exertion  and  great  physical  excitement  are  also 
said  to  be  predisposing  causes  of  this  disease. 

Pathological  Anatomy.  1.  Inflammation  of  the  Dura  Mater.  Pachy- 
meningitis.— The  tlura  mater  is  covered  with  a  numl)er  of  small  hemor- 
rhages. It  is  loose,  easy  to  tear,  and  over  the  surface  is  a  collection  of 
bloody,  purulent  masses  of  exudation.  In  the  later  stages  of  the  disease 
we  see  a  circumscribed  or  extended  thickening  and  adhesion  of  the  cov- 
ering to  the  base  of  the  skull  or  to  the  soft  cerebral-membrane. 


240  DISEASES  OF  THE  NERVOUS  SYSTEM 

2.  Inflammation  of  the  soft  Cerebral  Membrane.     Leptomeningitis. — 

The  arachiiuicl  is  looseiu'd  aiul  dull.  The  subarachnoid  chambers  are  filled 
with  more  or  less  turbid  fluid.  The  pia  mater  is  hypersemic,  loosened, 
and  covered  by  fibrinous  exudation.  The  coverings  of  the  brain  are  al- 
most always  infiltrated  and  detached  from  the  pia  mater  with  difficulty 
and  in  some  cases  we  find  a  serous  or  purulent  fluid  in  the  ventricles.  In 
a  chronic  case  we  find  a  circumscribed  thickening  of  the  cerebral  mem- 
branes and  adhesions  uniting  the  coverings  with  the  brain,  etc. 

3.  Inflammation  of  the  Brain  Mass.  Encephalitis. — This  disease,  as 
a  rule,  involves  single  centres  and  causes  a  general  irritation  of  the  healthy 
tissue  without  any  distinctly  marked  limit.  In  the  affected  regions  the 
substance  of  the  brain  is  swollen,  hypenemic,  and  frequently  filled  with 
small  hemorrhagic  centres.  In  the  course  of  time,  the  inflamed  cerebral 
substance  becomes  softened  and  pulpy.  This  condition  may  be  present 
without  any  hemorrhage,  but  as  a  rule,  the  brain  matter  becomes  red  and 
finally  yellowish.  This  latter  color  is  due  to  metamorphosis  of  the  color- 
ing substance  of  the  blood  or  to  fatty  degeneration.  These  conditions  are 
divided  into  white,  red,  or  yellow — softening  of  the  brain.  Finally  cic- 
atrices and  cysts  are  formed,  as  in  apojDlexy,  or  an  abscess  may  be  devel- 
oped which  is  filled  with  thick  yellow  or  greenish  pus,  which  later  becomes 
encysted  and  sometimes  solidified  (calcareous).  In  some  cases  small  en- 
cephalitic  centres  may  heal  without  leaving  any  trace.  Occasionally  we 
see  the  development  of  a  (non-inflammatory)  softening  of  the  brain  with 
thrombosis  and  embolus  of  the  arteries;  and,  as  a  general  rule,  we  find 
symptoms  which  resemble  apoplexy. 

Clinical  Symptoms. — The  symptoms  of  inflammation  of  the  brain  in 
its  early  stages  resemble  those  of  hyperaemia.  The  animals  are  excited; 
they  run  aimlessly  from  one  side  to  the  other,  and  are  fretful  and  irritable. 
They  whine  and  howl  constantly.  The  head  is  hot;  the  conjunctiva  is 
more  or  less  reddened,  the  pupils  are  contracted,  and  reflex  action  is  very 
slight.  The  appetite  is  lost;  constipation  is  generally  present,  with  more 
or  less  vomiting.  The  patient  is  indifferent  to  the  impressions  of  external 
objects,  being  sleepy  and  apathetic.  Soon  the  disease  changes  in  char- 
acter. We  see  acute  convulsions,  especially  those  of  the  jaw,  or  eclamptic 
convulsions.  The  animals  cry  and  howl.  At  the  same  time  the  sphinc- 
ters are  relaxed,  the  animal  apparently  having  no  control  of  them. 
Then  there  is  an  interval  of  quietness,  in  which  the  animal  falls  back  into 
a  deep  semicomatose  contlition,  and  between  these  periods  of  quietness, 
we  very  often  see  automatic  movements,  such  as  ([uivering  or  twitching  of 
one  or  two  of  the  legs;  also  the  corners  of  the  mouth  may  be  retracted. 
Many  cases  either  howl  constantly,  and  at  the  same  time  seem  to  be  semi- 
comatose, or  tliey  may  bark  hoarsely  (delirium).  As  a  rule,  the  temper- 
ature is  a  little  above  normal.     Within  a  short  time  the  aninuil  becomes 


COMPARATIVELY  RARE  DISEASES  OF  THE  BRAIN  241 

gradually  paralyzed,  losino;  all  power  of  the  muscles.  The  patient  is  dull 
and  unconscious  of  external  influences.  The  breathing  is  rattling  and 
stertorous.  The  pulse  is  increased  a  number  of  beats,  but  is  almost  im- 
perceptible to  the  touch.  The  temperture  now  begins  to  rise.  In  some 
cases  the  temperature  may  remain  normal,  and  in  rare  instances  falls  below 
normal.  As  a  rule,  the  animals  die  shortly  after  the  convulsions  make 
their  appearance.  Complete  recovery  is  very  rare,  and  slight  attacks  ter- 
minate as  a  rule  either  with  paralysis  (partial  or  complete),  idiotism,  or 
blindness. 

The  course  of  this  disease  varies  greatly  in  affections  of  the  cere- 
bellum. If  the  hemispheres  are  affected,  we  may  have  extensive  altera- 
tions of  the  brain,  which  may  run  their  course  without  any  decided  symp- 
toms being  shown;  but  as  soon  as  the  cerebellum  and  one  or  both  hemi- 
spheres become  affected,  we  then  see  the  various  symptoms  peculiar 
to  this  disease,  and  a  diagnosis  can  be  made  with  almost  absolute  certainty. 
In  disease  of  the  cerebellum  there  is  generally  an  unsteadiness  of  the 
gait  in  walking  and  peculiar  movements,  such  as  walking  around  in  a 
circle  and  rolling  on  the  ground,  when  both  hemispheres  are  involved. 
We  may  also  find  paralysis  of  the  posterior  extremities.  In  rare  instances, 
however,  these  symptoms  may  also  be  presented  in  cases  of  poisoning 
(by  cocaine  or  apomorphia). 

The  differential  diagnosis  betw^een  inflammation  of  the  brain,  con- 
gestion of  the  brain  and  rabies  is  taken  up  under  another  head. 

Very  similar  symptoms  to  those  already  described  appear  in  cases 
W'here  the  cysticercus  cellulosse  is  present  in  the  brain  or  its  membranes. 

Therapeutics. — The  treatment  of  inflammation  of  the  brain  cor- 
responds with  that  of  hypersemia  of  the  brain.  Rest,  confinement  in  a 
dark,  but  not  warm,  room,  cold  applications  to  the  head,  clysters,  laxa- 
tives, especially  calomel  and  in  cases  of  great  excitement,  sedatives  (mor- 
phia sulphas  0.02  subcutaneously,  chloral  hydrate  2.0  to  4.0,  by  the 
mouth,  or  per  rectum,  in  the  form  of  clysters).  The  violent  irritants 
which  were  formerly  used  on  the  skin,  such  as  croton  oil  or  cantharidal 
ointments  rubbed  on  the  inner  fascia  of  the  thighs  and  along  the  spine, 
are  of  no  particular  benefit,  in  fact  do  more  harm  than  good.  Food 
should  be  light,  and  easily  digested,  such  as  soup,  broth,  etc.,  and  to  as- 
sist in  the  reabsorption  of  the  exudate,  iodide  of  potassium  may  be  ad- 
ministered internally. 

Comparatively  Rare  Diseases  of  the  Brain. 

The  following  diseases  of  the  brain  are  rarely  seen,  but  a  description 
may  be  useful  to  the  practitioner. 

Chronic  Hydrocephalus. — This  condition  is  similar  to  what  is  known 
IG 


242  DISEASES  OF  THE  NERVOUS  SYSTEM 

as  a  "  dummy  "  in  the  horse,  and  it  may  be  congenital  or  it  may  follow  dis- 
temper. Frohner  found  twenty-nine  cases  in  70,000  dogs.  The  follow- 
ing symptoms  are  observed:  dulness,  head  inclined  to  one  side,  uncertain, 
irregular  gait,  with  a  tendency  to  go  to  one  side,  amaurosis,  deafness,  and 
loss  of  the  sense  of  smell.  On  post  mortem,  the  brain  on  section  is 
found  to  have  a  sero-lepto-meningitis,  with  large  collections  of  fluid 
in  the  ventricles;  in  some  cases  only  a  pachymeningitis  has  been  observed. 
The  treatment  consists  in  giving  laxatives.  Injections  of  pilocarpin,  as  a 
rule,  only  produce  a  slight  amelioration  of  the  symptoms. 

Sunstroke. — This  is  very  rare,  but  it  is  occasionally  seen  in  the 
working  dogs  of  European  countries,  wdiere  on  extremely  warm  days  the 
animals  pull  very  heavy  loads.  In  cases  where  the  animals  die,  we  find 
the  same  phenomena  observed  in  congestion  or  inflammation  of  the  brain. 
In  one  case  the  entire  muscular  system  was  filled  with  small  hemorrhagic 
centres,  much  hypenemia,  and  a  considerable  quantity  of  sero-sanguinous 
fluid.  Between  the  dura  mater  and  the  arachnoid  the  surface  of  the  brain 
was  covered  with  small  hemorrhages,  the  lungs  were  congested,  the  heart 
dilated  and  flabby,  and  full  of  dark  coagulated  blood.  Occasionally  an 
animal  may  die  without  any  premonitory  symptoms,  or  may  collapse 
suddenly,  having  a  very  strong  throbbing  pulse,  dyspnoea,  mouth  open  and 
tongue  hanging  out,  and  an  increase  of  temperature. 

Treatment. — This  is  similar  to  the  treatment  of  congestion  and  in- 
flammation of  the  brain;  rest,  cool  room,  cold  compresses  to  the  head  and 
if  there  is  great  depression,  stimulants  may  be  administered. 

Turning  Disease. — This  condition  is  indicated  by  the  animal  turning 
in  circles.  These  movements  are  involuntary  and  are  due  to  some  morbid 
process  of  the  brain  particularly  in  the  cerebellum,  especially  its  peduncles, 
such  as  hemorrhage,  inflammation,  embolus,  etc.,  and  it  may  also  result 
from  blows,  injuries  to  the  skull,  it  may  result  from  nervous  distemper,  or 
it  may  also  be  from  some  reflex  action.  Frohner  observed  it  in  constipa- 
tion, and  he  also  found  this  disease  in  twenty-nine  animals  in  an  observa- 
tion covering  70,000.  The  treatment  consists  in  keeping  the  animal 
perfectly  (juiet  and  the  adminstration  of  sulphonal,  hypnon  and  urethan. 

Edema  and  Parasites  of  the  Brain. — Edema  is  generally  found  on 
post  mortem  and  is  especially  interesting,  for  as  a  rule  there  is  not  the 
slightest  indication  of  this  condition  seen  during  life;  in  rare  cases  edema 
is  found  to  be  the  cause  of  a  variety  of  symptoms  during  life,  such  as 
monoplegia,  hsemiplegia,  hemianaisitasia,  involuntary  muscular  move- 
ments, ataxia,  convulsions,  and  from  the  increased  pressure  on  the  brain 
we  may  find  stupidity,  clumsiness,  giddiness,  and  fainting  spells. 

Parasites  produce  certain  ])rain  phenomena  and  particularly  from  the 
presence  of  the  cysticercus  cellulosa',  such  as  great  nervous  excitement, 
attacking  persons  without  cause,  involuntary  movements,  great  depres- 


INFLAMMATIOX  OF  THE  SPINAL  CORD  AXD  MEMBRANES    243 

sion,  coma  and  hlindnoss,  and  frecjucntly  every  sign  of  rabies  is  present. 

Progressive  Paralysis  of  the  Medulla  Oblongata. — This  is  called  in 
man  a  progressive  atrophy  of  the  medulla  oblongata.  This  condition 
presents  partial  paralysis  of  the  tongue,  of  deglutition,  of  the  larynx, 
of  the  lips.  It  is  extremely  doubtful  if  this  condition  does,  per  se,  occur 
in  the  dog,  it  being  due  to  some  other  condition  being  present  in  the 
brain.  Hutyra  and  Marek  have,  however,  seen  a  number  of  cases  of 
acute  paralysis  of  the  medulla,  particularly  paralysis  of  deglutition  and 
paralysis  of  the  tongue  (see  further  under  that  head). 

Cerebro -spinal  Meningitis  (Meningitis  Cerebro -spinalis).  Etiology. — 
Nothing  is  definitely  known  of  the  causes  of  this  disease.  It  is  extremely 
rare  in  the  dog.  Renner  and  Kempen  have  made  several  observations 
on  the  subject,  and  the  writer  had  one  case  of  his  own. 

The  anatomical  foundation  of  the  disease  seems  to  be  an  acute 
suppurating  inflammation  of  the  brain  and  spinal  membranes,  a  purulent 
exudation  in  the  arachnoid,  especially  on  the  hemispheres  and  the  base 
of  the  brain,  which  is  infiltrated  by  a  quantity  of  serous  fluid.  The  same 
condition  is  also  found  in  the  spine. 

The  symptoms  are  disturbances  of  the  sensory  nerves,  in  some 
cases  the  animal  becoming  unconscious.  There  were  loss  of  appetite, 
fever,  and  after  a  few  days  a  marked  unsteadiness  of  the  gait,  beginning 
with  a  slow,  dragging  walk,  and  difficulty  of  deglutition,  becoming  com- 
plicated with  tonic  convulsions  which  finally  became  epileptic,  staggering 
gait,  convulsive  movements  of  the  muscles  of  the  neck,  opisthotonos,  and 
lastly  stupor,  coma,  and  death. 

The  treatment  consists  in  the  administration  of  sedatives  such  as 
chloral  hydrate,  sulphonal  or  hedonal. 


DISEASES  OF  THE  SPINAL  CORD  AND  ITS  MEMBRANES. 

Inflammation  of  the  Spinal  Cord  and  Its  Membranes. 

{Myelitis  and  Spinal  Meningitis.) 

Etiology. — A  common  cause  of  myelitis  and  spinal  meningitis  is  trau- 
matisms of  some  kind  causing  direct  injuries  to  the  spine,  such  as  violent 
blows,  shocks  to  the  vertebral  column  by  falling  out  of  a  window,  etc., 
and  further  by  concussions  of  the  spinal  cord,  such  as  being  struck  by  an 
automobile  or  wagon.  Violent  muscular  exertions  frequently  produce 
this  condition.  In  very  rare  instances,  the  disease  may  follow  the  pres- 
ence of  an  abscess  on  the  outside  of  the  spinal  canal,  liy  extension  of  the 
suppurating  process  through  an  orifice  of  the  vertebra,  and  occasionally 


244  DISEASES  OF  THE  NERVOUS  SYSTEM 

you  see  it  originate,  in  connection  with  some  infectious  or  toxic  disease 
(distemper,  rabies,  pyaemia)  due  to  the  specific  toxic  material  locating 
in  the  cord.  It  may  also  be  caused  by  cold,  being  continually  wet  and 
frozen,  as  in  retrievers. 

Pathological  Anatomy. — The  inflamed  pia  mater  appears  thickened, 
infiltrated,  and  may  be  injected  in  some  places  and,  as  a  rule,  adherent  to 
the  vertebra,  due  to  the  organization  of  the  exudation.  It  is  covered 
on  its  upper  surface  by  a  serous,  fibrinous,  or  purulent  exudation.  The 
arachnoid  exudation  is  covered  by  a  milky,  false  membrane  and  greatly 
thickened.  The  dura  mater  is  rarely  involved,  but  when  such  is  the  case 
it  becomes  thickened  and  loosened  and  covered  with  a  thin  serum.  The 
spine  itself  shows  the  inflammatory  process  either  extended  over  large  sur- 
faces or  else  confined  to  small  centres.     In  the  early  part  of  the  disease, 


Fig.  94. — Paralysis  of  the  posterior  extremities. 

the  cord  is  slightly  swollen;  the  gray  substance  is  somewhat  reddened, 
dark  and  soft.  Later  the  cord  becomes  a  yellowish-red,  breaks  down  and 
undergoes  white,  yellow,  or  red  degeneration.  In  the  chronic  course  of 
the  disease  we  see  atrophy  of  the  nerves  as  a  conscc{uence  of  nuilforma- 
tions  of  the  connective  tissue. 

Clinical  Symptoms. — As  a  rule  the  symptoms  of  alteration  of  the  spinal 
cord  appear  gradually  and  become  more  intense  as  the  disease  progresses. 
Where  the  disease  is  due  to  violent  traumatisms,  producing  a  direct 
destruction  or  laceration  of  the  nervous  centres,  or  pressure,  caused  by 
hemorrhage  and  blood  l)eing  discharg(Ml  and  pressing  upon  the  spine  the 
symptoms  are  immediately  seen  or  appear  in  a  very  short  time.  In  all 
diseases  of  the  spinal  cord  it  is  very  inij)ortant  to  recognize  the  fact  that 
consciousness  is  rarely  affected.     We  will  take  up  all  these  symptoms  in 


INFLAMMATION  OF  THE  SPINAL  CORD  AND  MEMBRANES   245 

the  following  description,  which  may  be  observed  in  affections  of  the 
spinal  cord: 

Motor  symptoms  of  paralysis  are,  as  a  rule,  the  first  symptoms  pre- 
sented. The  patients  have  a  dull  heavy  look,  staggering  gait,  but  not 
irregular  (in  this  the  condition  differs  from  disease  of  the  cerebellum). 
Finally,  they  begin  to  drag  their  hind  legs  after  them  (Fig.  94),  the  poste- 
rior extremities  are  invariably  the  parts  paralyzed.  When  they  are  placed 
on  their  legs  they  stand  with  them  spread  apart,  or  they  may  simply  drop 
sideways  on  their  hind  cjuarters.  In  rarer  cases,  not  only  the  posterior  ex- 
tremities but  also  the  anterior  are  paralyzed,  and  it  is  evident  that  in 
cases  of  paralysis  of  all  the  members  the  spinal  substance  of  the  cervical 
region  must  be  affected,  while  paralysis  of  the  posterior  extremities  follows, 
no  matter  what  part  of  the  cord  is  affected.  In  these  cases  we  always 
have  the  double-sided  paralysis,  and  in  very  rare  cases  the  paralysis  may 
be  more  intense  on  one  side  than  the  other;  but  in  such  a  case  we  can 
only  suppose  that  in  one-half  of  the  spinal  cord  the  disease  is  more  ad- 
vanced than  in  the  other. 

In  the  early  stages  of  the  disease  there  are  slight,  irregular  twitchings 
of  the  extremities,  rarely  of  any  great  consequence,  and  seldom  leading 
to  convulsions.  There  may  be  marked  hypersesthesia  and  the  animal 
gnawing  continually  at  certain  points  of  the  body,  muscular  twitchings, 
drawing  in  of  the  hind  legs  toward  the  abdomen.  There  may  also  be  a 
continual  erection  of  the  penis,  and  the  evacuation  of  the  urine  and  faeces 
may  be  interfered  with  on  account  of  the  convulsive  contraction  of  the 
sphincter  or  paralysis  of  the  detrusor  urinae  and  muscles  of  the  intestine. 
We  also  observe  disturbances  of  sensitiveness  either  in  the  form  of  hy- 
persesthesia or  of  anaesthesia.  The  former  is  invariably  observed  in  the 
early  stages  of  the  disease;  the  patients  show  intense  pain,  especially  when 
touched,  lifted,  or  pressed  upon  the  spinal  cord.  (This  they  indicate  by 
biting,  howling,  etc.)  In  the  latter  case  they  do  not  show  the  slightest 
reaction  in  the  affected  regions,  even  when  subjected  to  serious  irritations 
of  the  skin.  It  must  be  remembered,  however,  that  symptoms  similar 
to  hyperaesthesia  may  also  be  present  in  rheumatism. 

In  mild  stages  of  this  disease  the  sphincters,  such  as  the  bladder 
and  rectum,  appear  slightly  affected.  In  the  more  serious  stage  we  ob- 
serve complete  paralysis,  loss  of  control  of  the  sphincters,  and  frequently 
complete  paralysis  of  the  sphincter  vesicae.  More  details  will  be  found  on 
this  subject  under  Diseases  of  the  Bladder.  Such  paralytic  conditions  of 
the  bladder  may  occur  in  all  diseases  of  the  spine.  There  is  difficulty  in 
the  passage  of  faecal  matter,  producing  constipation,  caused  to  a  certain 
extent  by  the  loss  of  abdominal  pressure.  Paralysis  of  the  sphincter  is 
evinced  by  a  gaping  rectum  and  the  involuntary  escape  of  faecal  matter 
which  accumulates  in  the  lower  bowel.     Through  want  of  active  exercise, 


246  DISEASES  OF  THE  NERVOUS  SYSTEM 

the  muscular  system  of  paralyzed  animals,  especially  the  extremities,  be- 
comes flabby,  soft  and  atrophied.  The  temperature  is  reduced  in  the  par- 
alyzed portion,  the  extremities  being  cold  and  anaemic.  In  cases 
where  there  is  paralysis  of  the  spinal  cord  caused  by  compression,  and  in 
cases  of  atrophy  due  to  hemorrhage  on  the  spinal  cord,  and  also  in  certain 
luxations  or  fractures  of  the  vertebrae,  we  practically  see  the  same  symp- 
toms. Paralysis  of  the  extremities,  particularly  the  posterior,  may  result 
from  the  following  conditions: 

a.  Paralysis  of  the  spinal  cord  caused  by  compression  may  result 
from  thickening  of  the  membranes  and  pressure  on  the  spine  itself.  It 
may  also  occur  in  some  diseases  of  the  vertebra?,  for  instance  in  exostosis, 
but  both  of  these  conditions  are  very  rare.  In  such  cases  the  symptoms 
come  on  very  slowly  and  gradually  increase  in  intensity. 

d.  Apoplexy  may  occur,  due  to  the  presence  of  some  blood  escaping 
on  the  spine  and  causing  pressure.  In  these  cases  the  paralysis  appears 
very  suddenly,  but  may  gradually  disappear  after  some  time. 

c.  Luxations  of  the  spinal  column  only  happen  in  the  vertebra  of  the 
neck,  and  cause  a  peculiar  oblique  position  of  the  head,  as  if  it  were  twisted 
to  one  side.  This  is  due  to  displacement  of  the  ligaments.  At  the 
same  time  there  is  present  a  series  of  what  might  be  called  "  special  symp- 
toms," which  are  not  very  pronounced  in  any  of  their  characters. 

b.  Fractures  of  the  spine:  These  are  generally  recognized  by  some 
change  in  the  position  of  the  region  in  which  they  are  located  (bending 
inward,  flattened  depressions,  and  in  rare  instances  slight  distortions  of 
the  spinal  cord),  and  also  by  the  extensive  sensitiveness  to  pressure  in 
this  location.  In  certain  instances  there  may  be  an  al^normal  mobility  of 
the  part.  Crepitation,  as  a  rule,  is  absent.  In  fractures  of  the  cervical 
vertebrae,  we  generally  notice  an  ol^liciue  position  of  the  head.  If  the 
symptoms  just  described  are  absent,  when  an  animal  has  had  a  severe  fall 
on  the  spine,  unless  paralyzed,  or  remains  without  loss  of  consciousness, 
it  is  always  doul)tful  if  there  is  a  fracture  of  the  vertebnp  or  a  hemorrhage 
within  the  vertebral  canal.  In  such  cases  we  simply  have  to  await  develop- 
ments, or  if  paralysis  docs  not  immediately  follow  the  injury,  but  comes 
some  time  afterward,  it  is  due  to  compression  of  the  spine  from  a  grad- 
ually increasing  hemorrhage,  ^^'e  must  I'emember,  however,  that  a  fall, 
shock,  or  blow  upon  the  back,  or  ordinary  irritations  of  the  spinal  sub- 
stance may  occur,  like  a  concussion  of  the  brain,  in  which  there  is  not  the 
slightest  alteration  to  be  found  in  the  spinal  substance  or  its  memliranes. 
In  many  cases  we  may  expect  a  recovery  as  long  as  there  are  no  myelitic 
complications. 

Chronic  Inflammation  of  the  Spinal  Cord. — This  condition  follows  as 
a  sequence  to  the  acute  foi'm  or  it  commences  at  the  onset  as  a  gradual 
progressive  affection.      It  has  been  contended  that  overstimulation  of  the 


INFLAMMATION  OF  THE  SPINAL  CORD  AND  MEMBRANES   247 

sexual  organs  is  an  exciting  cause,  but  this  is  not  admitted  by  all  ob- 
servers. Chronic  inflammation  of  the  cord  is  indicated  by  disturbances  of 
mobility,  the  animal  is  easily  tired  on  very  slight  exertion,  shows  a  want 
of  coordination  in  walking,  great  difficulty  in  rising  after  lying  down  for 
some  time,  regular  or  irregular  twitching  of  the  muscles  in  the  affected 
extremities,  or  complete  paralysis  of  the  hind  quarters  and  in  very  rare 
instances  of  the  anterior  limbs,  more  or  less  disturbance  of  the  sphincters, 
and  gradual  atrophy  of  the  affiected  muscles.  The  appetite  is  invariably 
good  and  there  is  no  rise  of  temperature. 

Pachymeningitis  spinalis  ossificans,  that  peculiar  disease  indicated  by 
a  gradual  ossification  of  the  spinal  membranes,  is  not  at  all  uncommon  in 


Fi3.  95. — ParalysLs  of  the  cord. 


dogs  of  an  advanced  age.  This  disease  consists  of  a  gradual  inflamma- 
tory process  of  the  dura  mater,  in  which  that  tissue  gradually  becomes 
filled  with  numerous  irregular  or  massed  collections  of  tolerably  firm 
bony  scales,  situated  on  the  ventral  surface  of  the  tissue,  particularly 
in  the  region  of  the  cervical  and  lumbar  regions  of  the  cord.  The 
whole  dura  mater  may  become  converted  into  a  hard  bony  tube,  and  in 
exertion  of  the  body  the  roots  of  the  nerves  may  be  torn  from  the  spine. 
The  ossific  hardening  of  the  dura  may  be  present  for  a  long  time  be- 
fore any  actual  clinical  symptoms  are  present  (Cadeac)  and  are  gener- 
ally produced  by  laceration  of  the  sensory  nerve  fibres,  by  violent  or 
unusual  movements,  or  movements  in  a  certain  direction  of  the  spine.  The 
voluntary  movements  of  the  animal  are  cautious,  stiff,  or  stilty,  either  on 
walking  about,  lying  down,  getting  up  or  climbing  up  stairs;  the  latter  he 
may  refuse  to  do,  and  on  forcibly  bending  the  spinal  column  the  animal 


248 


DISEASES  OF  THE  NERVOUS  SYSTEM 


may  evince  pain.  The  back  is  turned  or  crooked  to  one  side,  the  hind  legs 
being  carried  forward  under  the  abdomen  (Fig.  95).  Frec^uently  the 
animal  may  cry  out,  howl  or  show  great  pain  on  certain  movements  or 
positions  of  the  body,  the  same  movement  apparently  he  may  have  done 
a  few  moments  before  without  showing  the  slightest  pain.  This  condition 
is  frequently  mistaken  for  acute  muscular  rheumatism.  In  rare  cases  the 
animal  carries  the  hind  quarters  in  the  air  and  balances  the  body  on  the 
anterior  limbs  (Fig.  90) ,  and  gradually  there  is  a  great  increase  in  the  mus- 
cular development  of  pectoral  and  thoracic  muscles;  as  a  rule  there  is  a 
tendency  to  retention  of  the  fseces  and  urine,  but  there  may  also  be  invol- 
untary passage  of  urine  and  faeces.  The  appetite  is  generally  impaired, 
the  reflexes  are  impaired  and  the  penis  may  either  be  erected  or  protruded 


Fig.  96. — Dog  with  pachymeningitis  ossificans.     Characteristic  position  of  body  in  walking. 


beyond  the  prepuce.  The  disease  may  vary  to  a  certain  extent  in  inten- 
sity, but  sooner  or  later  the  paralysis  increases,  either  involving  one  leg 
more  than  another  or  the  entire  hind  quarters  are  affected;  gradually  the 
sensibility  decreases  and  the  animals  show  entire  loss  of  muscular  power 
and  pain  in  the  affected  parts. 

Therapeutic  Treatment  of  the  Diseases  of  the  Spinal  Cord. — In  the 
early  stages  of  the  disease  when  fever,  hypersesthesia,  and  convulsions 
give  pronounced  evidence  of  the  disease,  it  is  advisable  to  give  anti- 
phlogistic treatment,  consisting  of  cold  compresses  (ice  bags)  upon  the 
spinal  cord,  and  vigorous  purgatives  (calomel),  saline  purgatives,  and 
lastly  enemas.  In  cases  where  the  paralytic  symptoms  predominate, 
we  use  irritants  along  the  spinal  column,  such  as  painting  with  can- 
tharidal,  collodion,  or  dilute  croton  oil,  viz.,  oleum  crotonis  0.5,  ol.  tere- 
binthin  15.0;  this  j^reparation  is  rubbed  into  the  skin  along  the  vertebral 


INFLAMMATION  OF  THE  SPINAL  CORD  AND  MEMBRANES   249 

column  by  means  of  a  woolen  cloth;  blistering  with  biniodide  of  mer- 
cury or  the  use  of  the  actual  cautery,  in  the  form  of  pin-point  firing 
along  the  spine.  Sometimes  in  mild  cases  use  an  inunction  of  mustard 
oil.  If  great  pain  is  present  use  morphine,  chloral  hydrate,  or  sul- 
phonal.  If  we  succeed  in  lessening  the  convulsions,  or  if  the  paralytic 
symptoms  predominate,  we  must  use  stimulants  such  as  strychnia  and 
electricity.  The  first  should  be  used  internally  in  the  form  of  tincture  of 
nux  vomica,  from  five  to  twelve  drops,  or  subcutaneously  in  a  strychnia 
solution;  the  latter  method  is  better.  We  must  remember  that  one  daily 
injection  is  sufficient,  and  that  a  medical  pause  of  from  thirty-six  to 
forty-eight  hours  ought  to  be  made  every  four  or  five  days  in  order  to 
prevent  the  cumulative  influence  of  this  drug. 

TJ.     Strychnia  muriate,  0.005 

Aqua,  5.0 

Electricity  is  applied  in  the  following  method:  after  having  pre- 
viously dampened  the  region  with  a  concentrated  saline  solution  one 
pole  of  the  battery  is  placed  on  the  spine  and  the  other  at  the  termination 
of  the  paralyzed  limb.  For  instance,  one  is  put  on  the  foot  and  the 
other  in  the  middle  or  side  of  the  spine,  gradually  increasing  the  current. 
In  such  cases,  besides  administering  a  purgative  and  cleansing  the  bowels, 
we  must  also  see  that  the  bladder  is  emptied  by  means  of  a  catheter. 
Electricity  is  also  a  useful  agent  in  peripheral  paralysis,  which  has  been 
mentioned.  The  faradic  current  is  preferable.  Place  one  of  the  poles  as 
close  as  possible  to  the  point  of  central  location  of  the  affected  nerves 
and  gently  run  over  the  paralyzed  muscles  with  the  other  pole.  This 
treatment  should  be  renewed  every  day  for  ten  or  fifteen  minutes. 
Alcoholic  frictions,  such  as  spirits  of  camphor,  tincture  of  arnica,  bay  rum, 
opodeldoc  liniment,  are  to  be  recommended  when  used  in  connection 
with  true  massage  (pinching,  friction,  and  massage  of  the  paralyzed 
muscle  in  its  proper  direction).  Warm  baths  are  said  to  be  useful.  As 
a  means  to  promote  reabsorption,  administer  iodide  of  potassium  0.09 
internally.  Subcutaneous  injections  of  eserine  and  pilocarpine,  or  pilo- 
carpine alone  may  be  used  if  it  is  suspected  that  a  large  amount  of  fluid 
exudate  is  on  the  cord.  On  account  of  the  toxic  properties  of  these 
drugs,  great  care  must  be  used  in  their  administration.  The  bladder 
must  also  be  emptied  by  either  pressure  on  the  abdominal  wall  or  by 
catheterization,  and  the  rectum  emptied  by  means  of  clysters  and  the 
food  must  be  such  as  will  digest  easily. 

In  cases  of  ossific  pachymeningitis,  Cadeac  and  others  recommend 
friction  with  strong  liniments,  actual  cautery,  or  setons,  along  the  spinal 
column  as  well  as  painting  the  spine  with  tincture  of  iodine,  and  also 
the  internal  administration  of  iodide  of  potassium,  salicylate  of  soda, 


250  DISEASES  OF  THE  XERVOUS  SYSTEM 

salol,  salophen,  antipyrin,  etc.  As  a  tonic  strychnia  should  be  used  in 
combination  with  arsenic  or  quinine  and  lastly  the  galvanic  current 
has  produced  good  results  in  some  cases. 

I^.     Strychnine  muriate,  0.005 

Aqua  distil.,  5.0 

M.  F. 
Sig. — As  a  hypodermic  of  1.0  to  be  injected  once  daily. 

I^.    Physostigmin  sulph.,  0.05 

Pilocarpin  muriate,  0.1 

Aqua  distil..  20.0 

M.  F. 

Sig. — 1.0  injected  every  three  days. 

Certain  Diseases  of  the  Spinal  Cord. 

The  following  diseases  are  caused  directly  and  indirectly  by  some 
change  or  morbid  condition  of  the  spinal  cord. 

Compression  of  the  Spinal  Cord.  Myelitis  by  Compression. — By 
this  name  is  understood  a  slow  compression  of  the  cord;  due  to  a  patho- 
logical process  which  alters  and  straightens  the  vertebral  canal;  this  may 
be  due  to  thickening  of  the  membranes  as  in  pachymeningitis  spinalis 
ossificans,  already  mentioned,  from  tumors  of  the  vertebra  or  meninges, 
exostoses  or  inflammations  of  the  intervertebral  discs.  As  to  tumors  in 
the  vertebral  column  very  little  is  known  in  dogs;  sarcoma;  cholestea- 
toma, and  melanoma  have  been  found  by  a  number  of  observers,  ex- 
ostoses projecting  into  the  vertebral  column  may  be  caused  by  periostitis 
of  the  intervertebral  discs  of  the  lumbar  region;  this  is  frequently  seen  in 
old  clogs.  Inflammation  of  the  intervertebral  discs  is  caused  by  violent 
and  continued  jumping,  particularly  in  performing  dogs.  These  forma- 
tions are  at  first  soft  formations,  which  later  become  hard  and  project 
into  the  vertebra  and  in  advanced  cases  project  from  one  vertebra  to 
another  in  spine-like  processes.  While  the  dorsal  lumbar  vertebrae  are 
the  most  frequently  afTected,  it  has  also  been  observed  in  the  cervical 
portion  of  the  column. 

Clinical  Symptoms. — The  symptoms  are  those  we  would  find  as  a  re- 
sult of  compression  of  the  spinal  cord  and  the  origin  of  the  nerves.  The 
animal  at  intervals  shows  pain,  moaning,  barking  or  howling,  stiff  cautious 
movements,  and  evidence  of  partial  or  complete  paralysis  of  certain  mus- 
cles of  the  body,  also  motive  disturbance  of  the  bladder  and  rectum,  erec- 
tion of  the  penis.  Certain  valvular  diseases  of  the  heart,  causing  a  venous 
hypersemia,  arterial  anaemia  of  the  medulla  spinalis  or  thrombus  of  the 
femoral  arteries  produce  symptoms  similar  to  this  disease,  and  it  is  well 
to  carefully  examine  the  heart  in  a  case  of  spinal  paralysis.  The  treat- 
ment is  useless,  as  it  is  incurable. 


CERTAIX  DISEASES  OF  THE  SPINAL  CORD  251 

Hemorrhage  of  the  Spinal  Cord.  Apoplexia  Spinalis. — Hemorrhage 
maj'  occur  between  the  membranes  of  the  cord  as  well  as  in  the  cord  itself, 
and  in  most  instances  is  due  to  traumatic  influences.  One  observer  found 
in  a  dog  that  fell  while  running  very  fast  a  profuse  subdural  hemorrhage 
extending  from  the  second  cervical  vertebra  to  the  sacrum;  there  was 
also  more  or  less  hemorrhage  in  the  central  sections  of  the  spine  of  the 
cervical  and  lumbar  regions;  the  animal  lived  three  days. 

The  clinical  symptoms  either  as  convulsive  twitching  or  paralysis 
appear,  but  may  disappear  very  quickly  if  the  blood  is  reabsorbetl,  or 
the  animal  dies  in  a  short  time.  In  some  cases  partial  or  complete  paraly- 
sis may  follow  as  a  result  of  the  hemorrhage. 

The  treatment  consists  in  absolute  rest,  cold  compresses  to  the  spine, 
and  the  internal  administration  of  iodide  of  potassium.  Much  better 
results  are  to  he  expected  if  the  case  is  treated  at  its  onset. 

Fractures,  Luxations,  Diastasis  of  the  Vertebral  Column. — Fracture 
of  the  vertebral  column  is  caused  by  blows,  falls,  being  run  over  by  a 
wagon  or  automobile,  and  is  detected  by  deformity  or  curve  of  the 
vertebral  colunni,  by  pain  on  pressure  and  want  of  mobility  of  the  spine. 
It  is  extremely  difhcult  in  fracture  of  the  spine  to  get  actual  crepitation. 
In  fracture  of  the  lumbar  vertebra  and  of  the  sacrum,  the  place  of  fracture 
may  sometimes  be  felt  by  introducing  the  finger  into  the  rectum  and 
feeling  along  the  column.  Fracture  of  the  cervical  vertebra  invariably 
causes  death  in  a  very  short  time,  that  is  if  the  arch  of  the  vertebra  is 
broken,  but  frecjuent  recoveries  are  made  where  the  fracture  is  of  the 
transverse  or  oblique  processes.  If  the  latter  are  injured,  the}-  heal 
leaving  a  torsion  or  crookedness  (torticollis).  Fractures  of  the  lumbar 
or  sacral  region,  while  not  necessarily  fatal,  cause  such  helplessness  and 
misery  that  the  animal  should  be  mercifully  destroyed. 

Luxations  (diastasis)  of  the  spine  without  fracture  are  extremely 
rare,  although  we  may  occasionally  find  distortion  or  sprain  of  the  cord 
with  compression  and  tearing  of  the  vertebral  discs.  In  such  cases  the 
prominent  symptoms  are  great  rigidity  of  the  vertebral  column,  stilted 
gait,  local  pain  on  pressure.  The  symptoms  may  disappear  quickly  or 
they  may  increase  rapidly  and  develop  into  acute  inflammation  of  the 
intervertebral  discs  (see  page  250).  Rest,  Priessnitz  compress  on  the 
lumbar  region,  later  on  local  friction  or  massage  of  the  afTected  part. 

Concussion  of  the  Spinal  Cord.  Commotis  Medullae  SpinaUs. — This 
is  apt  to  occur  from  the  same  causes  as  produce  commotis  cerebri.  This 
condition  may  be  present  and  the  animal  be  completely  paralyzed  and  no 
change  is  found  in  the  vertebral  column.  Frequentl}''  animals  affected 
in  this  way  make  a  very  speedy  recovery  and  it  is  not  wise  in  doubtful 
cases  to  destroy  the  animal  too  hastily. 

Tabes  Dorsalis. — This  disease  is  a  degeneration  and  atrophy  of  the 


252  DISEASES  OF  THE  NERVOUS  SYSTEM 

spinal  cord,  found  as  a  result  of  syphilis  in  man.  Friedberger  and  Froh- 
ncr  thought  they  found  it  in  the  spinal  cord  of  several  dogs  that  had 
ataxia.  The  writer  is  of  the  opinion  that  it  does  not  occur  in  the  canine 
race,  for  among  the  thousands  of  dogs  he  has  posted  he  has  yet  to  see  a 
case  that  he  could  consider  was  affected  with  the  disease. 

Syringomyelia. — Lienaux  describes  one  case  of  this  peculiar  disease, 
which  is  characterized  by  fissures  and  hollows  in  the  cord.  The  disease 
developes  very  slowly;  at  the  onset  we  find  disturbances  of  mobility, 
weakness,  paralysis  of  the  posterior  extremities,  the  animal  has  a  peculiar 
hyena-like  walk,  urination  and  defecation  remain  normal,  the  appetite 
is  good,  sensation  in  the  posterior  extremities  and  later  in  the  anterior 
extremities  is  gradually  lost.  On  examining  the  spine,  it  is  found  to 
contain  a  number  of  cavities  filled  with  clear  serum;  these  cavities  are  in 
the  gray  matter,  particularly  in  the  posterior  section,  and  in  the  com- 
missures of  the  anterior  section  of  the  cervical  and  dorsal  regions. 

Paralysis  of  the  Nerves. 

Paralyzed  nerves  may  be  due  to  some  morbid  process  of  the  central 
nervous  system,  also  to  traumatisms,  such  as  tearing  or  bruising  of  the 
nerves,  or  compressing  the  nerves  by  neoformations,  hemorrhagic  ex- 
travasations, exudates,  enlarged  lymphatic  glands,  swollen  tissues,  dis- 
located bones,  etc.  Inflammation  and  subsequent  paralysis  of  the  nerves 
may  also  be  caused  by  cold  (neuritis  rheumatica),  by  paralysis  or  paresis, 
causing  an  atrophy  of  a  muscle  or  group  of  muscles,  and  in  the  case  of  a 
mixed  nerve  going  to  a  certain  part,  to  have  disorder  of  sensation,  neu- 
ralgia, or  anaesthesia.  Convulsions  are  extremely  rare  and  if  they  appear 
would  indicate  some  central  pathological  process. 

We  will   take  up   particularly  paralysis   of  the  peripheric  nerves. 

Paralysis  of  the  Facial  Nerve. — The  most  frequent  cause  of  this 
condition  is  disease  of  the  middle  ear,  caries  of  the  petrous  bone,  neo- 
formations or  inflammatory  processes  of  the  region  of  the  parotids, 
traumatisms  at  the  place  where  the  nerve  goes  around  the  maxillary 
or  the  periphery  of  the  nerve,  cold — this  latter  cause,  however  is  rare; 
also  to  pathological  processes  in  the  skull  and  base  of  the  brain,  or  it  may 
follow  as  a  result  of  distemper.  Generally  the  affection  is  unilateral 
(monoplegia  facialis).  A  bilateral  paralysis  (diplegia  facialis)  is  in- 
variably of  central  origin. 

In  the  case  shown  in  the  accompanying  figure  (Fig.  97)  the  symptoms 
were  as  follows:  The  end  of  the  nose,  the  superior  and  inferior  lip  and 
the  chin  turned  to  the  right  side,  the  left  eye  was  wide  open  and  could 
not  be  closed,  the  left  cheek  was  relaxed  and  sunken,  the  left  ear  hung 
downward  and  backward  and  could  not  be  lifted  by  the  animal,  as  was 


PARALYSIS  OF  THE  NERVES 


253 


the  right  ear  when  the  animal  was  called,  or  his  attention  attracted,  the 
animal  ate  with  difficulty  but  drank  water  normally.  The  cause  of  this 
condition  was  not  defined.  The  animal  was  treated  with  the  faradic 
current  and  in  ten  days  was  discharged  cured.  A  number  of  observers 
report  favorable  recoveries. 

Motor  Paralysis  of  the  Trigeminus.  Paralysis  of  the  Masseter  Muscle. 
Submaxillary  Paralysis. — This  form  of  paralysis  is  a  common  symptom 
of  rabies;  therefore  all  cases  of  this  kind  must  be  regarded  with  suspicion. 

It  is  observed  following  distemper,  in  hemorrhagic  gastro-enteritis, 
and  also  as  a  result  of  certain  forms  of  bacterial  poisons,  and  also  in  some 


Fig.  97. — Facial  paralysis  of  the  left  side. 


affections  of  the  brain,  morbid  processes  at  the  base  of  the  cranium,  such 
as  hemorrhages,  neoformations,  gliosarcoma.  It  would  appear  at  times 
as  if  the  motor  nuclei  of  the  trigeminus  are  sciueezed  by  the  muscles  of  mas- 
tication, for  instance  when  great  effort  is  made  to  bite  and  crush  partic- 
ularly large  bones.     Rheumatic  influences  are  also  said  to  cause  it. 

The  chief  symptoms  are  as  follows:  the  mouth  remains  open,  the  in- 
ferior maxillary  hanging  limp;  if  paralysis  continues  for  any  length  of 
time,  the  muscles  atrophy.     Recovery  is  rare. 

Paralysis  of  the  Radial  Nerve. — This  is  very  rare  and  occurs  as  a  re- 
sult of  traumatism  or  a  sequela  to  distemper  or  cold.  As  the  radial  nerve 
controls  the  muscles  of  extension  of  the  leg,  the  anconeus  muscle  and 
extensor  muscles  of  the  forearm  the  animal  is  unable  to  extend  the  leg  but 


254  DISEASES  OF  THE  NERVOUS  SYSTEM 

keeps  it  bent  with  the  foot  turned  back  and  steps  on  the  front  of  the  foot 
in  walking  as  it  is  dragged  along,  the  muscles  of  the  leg  become  atrophied, 
and  the  animal  stumbles  and  staggers  when  walking.  Partial  paralysis 
may  result  from  tumors  or  fractures  of  the  scapula  or  to  injuries  to  the 
region  of  the  shoulder,  particularly  when  an  animal  going  at  great  speed 
strikes  the  shoulder  against  some  hard  object.  Recoveries  from  this 
condition  are  quite  common. 

Paralysis  of  the  Ischiadicus. — This  is  rare  and  occurs  as  a  result  of 
blows,  falls,  as  a  result  of  distemper,  and  from  unknow^n  causes;  there  may 
also  be  observed  a  cross  paralysis  of  the  hind  quarters  and  also  one  ante- 
rior limb.  The  hind  leg  is  dragged  and  the  skin  worn  off  the  dorsal  face  of 
the  toes,  but  the  animal  can  sit  on  the  affected  leg  if  it  is  brought  into 
position.  One  observer  has  seen  paresis  of  the  peroneus  in  a  hunting  dog; 
in  walking  about  every  ten  or  twelve  steps  the  animal  made  an  extra  long 
step  and  when  the  animal  sat  down  the  hind  leg  was  turned  backward  and 
upwards.  One  case  was  caused  by  the  animal  being  injured  while  creeping 
under  a  Ijed. 

Paralysis  of  the  Cruralis  Nerve.  Paralysis  of  the  Femoralis  and  Quad- 
riceps.— In  this  case  the  animal  cannot  step  with  the  hind  leg  as  the 
articulations  flex  abnormally;  this  condition  is  quickly  followed  by 
atrophy  of  the  quadriceps.  One  observer  could  define  no  cause  for  the 
condition,  and  the  animal  made  a  good  recovery  in  five  weeks. 

Paralysis  of  the  Obturator  Nerve. — One  case  of  this  kind  was  described 
by  .Schimmel  in  which  a  ladder  fell  on  the  animal.  When  the  animal 
walked,  the  one  leg  was  curved  and  at  each  step  it  was  thrown  outw^ard 
and  forward  and  there  was  great  atrophy  of  the  adductor  muscles.  Reg- 
ular exercise  led  to  a  gradual  improvement  of  the  condition. 

Prognosis  and  Treatment  of  Paralysis  of  the  Nerves. — The  prognosis 
can  never  be  regarded  as  favorable;  it  is  true  certain  cases  already  men- 
tioned have  recovered,  but  the  majority  of  cases  are  always  to  be  regarded 
as  doubtful,  particularly  when  their  peripheric  nerves  have  undergone 
some  pathological  change. 

The  first  thing  to  endeavor  to  do  is  to  try  and  remove  the  cause  of 
the  irritation  of  the  nerve;  if  this  is  due  to  the  presence  of  a  tumor,  ex- 
travasation of  blood  or  serum,  cicatricial  tissvie  or  dislocation  of  an 
articulation  we  endeavor  to  remove  the  exciting  cause  or  lessen  the  in- 
flammatory or  purulent  conditions  in  the  neighborhood  of  the  nerve. 
If  a  rheumatoid  cause  is  suspected,  administer  salicylic  acid,  salol,  aspirin, 
or  antipyrin.  Massage  may  also  be  used  combined  with  a  certain  amount 
of  well  regulated  exercise.  The  electric  current  may  be  eniployed,  the 
negative  electrode  being  applied  as  near  the  root  of  the  nerves  as  pos- 
sible, and  the  positive  pole  is  moved  along  the  branches  of  the  nerve  and 
the  affected  muscles. 


,  EPILEPSY  255 

Polyneuritis  Infectiosa. — Under  this  name  Sellman  describes  a  case 
of  an  adult  terrier  which  is  similar  to  primary  multiple  neuritis  in  man. 
The  posterior  extremities  of  the  animal  were  completely  paralyzed,  and 
their  temperature  was  slightly  lower  than  the  rest  of  the  body,  the  spinal 
reflexes  were  gone,  with  slight  opisthotonos,  and  hyperesthesia  in  various 
parts  of  the  body,  the  heart  being  weak.  As  the  disease  advanced,  a  herpes 
eruption  appeared,  and  nodules  appeared  along  the  course  of  the  following 
nerves:  tibialis,  ischiadicus,  peroneus  and  cruralis.  The  animal  was  given 
warm  baths,  later  cold  showers  and  massage,  and  gradually  the  symptoms 
disappeared  and  in  three  months  the  dog  had  entirely  recovered. 

Facial  Twitchings.  Facial  Spasms. — Muscular  twitchings  occur  in 
the  region  of  the  facialis,  as  a  sequence  to  distemper  and  also  in  chorea; 
and  occasionally  they  occur  in  meningitis  and  certain  forms  of  en- 
cephalitis; one  case  described  by  Cadiot,  Gilbert  and  Rogers  was  named 
"Tic  de  la  face,"  where  the  twitching  followed  distemper,  and  was  cured 
by  the  removal  of  the  bulbus  (original  nuclei)  of  the  facialis.  There  is  no 
relationship  between  facial  twitchings  of  the  dog  and  the  *'  tic  convulsiva  " 
of  man. 

Epilepsy. 

(Falling  Sickness.) 

Epilepsy  is  a  disease  of  the  brain,  which  is  not  rare  in  the  dog.  It  is 
chronic  in  its  course,  and  appears  to  be  hereditary.  Its  chief  symptoms 
are  irregular  attacks  of  unconsciousness  and  in  older  cases  accompanied  by 
acute  characteristic  muscular  convulsions.  True  idiopathic  epilepsy,  gen- 
erally incurable,  is  frequently  confounded  with  the  so-called  symptomati- 
cal  epilepsy,  that  is  the  epileptiform  convulsions  which  appear  as  a 
symptom  of  grave  pathological  conditions  of  the  brain,  or  some  other 
change  in  the  skull  such  as  reflex  irritation  of  the  peripheral  nerves. 

Etiology  and  Pathological  Anatomy. — The  causes  of  epilepsy  are  un- 
known, but  at  the  same  time  there  is  no  doubt  that  certain  diseases  of  the 
brain  and  its  membranes,  especially  chronic  diseases,  have  recently  been 
demonstrated  by  Otto  to  be  hereditary.  This  disease  may  appear  at  any 
time  during  life,  and  even  in  advanced  age;  great  excitement  and  fear 
seem  to  play  some  part  in  its  development.  Wasting  diseases  very  fre- 
quently cause  epileptiform  seizures  which  are  similar  to  true  epilepsy,  and 
we  may  also  observe  in  some  cases  a  reflex  epilepsy  which  does  not  re- 
semble true  epilepsy  in  any  way  except  in  some  general  symptoms.  These 
will  happen  after  traumatic  lesions  of  the  peripheral  nerves,  in  animals 
harboring  intestinal  parasites,  and  in  animals  having  poisonous  sub- 
stances in  the  intestines.  We  may  also  observe  epileptiform  convulsions 
in  distemper. 


256  DISEASES  OF  THE  NERVOUS  SYSTEM 

In  true  epilepsy  there  are  no  anatomical  alterations  to  be  found  in 
the  brain  itself.  Whenever  they  are  found  they  cause  epileptiform  con- 
vulsions. It  is  therefore  certain  that  in  a  case  of  epilepsy  it  is  only  due  to 
some  temporary  irritating  condition,  and  that  the  membranes  of  the 
brain  are  the  starting-point  of  the  irritation. 

The  experiments  which  have  been  made  upon  dogs  in  connection  with 
this  disease  by  Ferrier,  Eulenberg,  Landois,  and  others,  are  very  interest- 
ing. They  found  that  with  great  irritation  of  the  motor  regions  of  the 
large  brain  (the  cerebrum)  a  complete  attack  could  be  produced.  This 
begins  with  twitching  of  the  muscles  which  belong  to  that  centre.  It 
then  becomes  extended  over  the  corresponding  group  of  muscles  on  the 
other  side,  producing  shocks  and  twitching  of  the  whole  muscular  system 
of  the  body  from  tonic  and,  later,  clonic  convulsions.  The  convulsions 
extend  from  centre  to  centre,  and  they  never  miss  any  region,  but  run 
consecutively  from  one  to  the  other.  If  the  chief  centre  is  cut  out,  the 
convulsions  will  not  be  present  in  that  region  during  the  epileptiform 
attacks.  Irritation  of  the  subcortical  white  substance  of  the  brain  also 
causes  epilepsy.  This  begins,  however,  in  the  muscles  of  the  same  side. 
Bromide  of  soduim  administered  for  some  time  has  been  found  very 
valuable  in  preventing  epilepsy  caused  by  membranous  irritation. 

From  the  above  experiments  it  can  be  readily  understood  that  the 
cortex  of  the  cerebrum  is  the  original  centre  of  epileptic  attacks.  It  is 
hard  to  explain,  however,  the  actual  cause  of  this  irritation.  Epilepsy 
can  hardly  be  caused  by  overstimulation  or  feeding,  for,  as  a  rule,  the 
largest  number  of  true  epileptic  subjects  are  weak,  delicate,  and  anaemic; 
but  at  the  same  time  we  often  see  vigorous,  well-fed  dogs  of  all  ages  suffer- 
ing from  this  disease.  There  are  many  cases  in  anaemic  animals  which, 
under  treatment,  gradually  improve,  at  the  same  time  the  epileptiform 
attacks  becoming  less  and  less  as  the  animal  improves.  It  is  doubtful  if 
these  cases  can  1)0  called  true  epilepsy. 

Clinical  Symptoms  and  Course  of  the  Disease. — In  acute  attacks  of 
epilepsy  the  symptoms  begin  suddenly,  or  they  may  start  with  slight 
premonitory  symptoms,  or  we  may  see  both  forms  alternately  in  dif- 
ferent seasons  in  the  same  individual.  In  the  early  stages  the  animals 
run  in  a  circle,  are  restless,  have  a  staring  look  out  of  their  eyes,  or  remain 
standing  with  outstretched  legs  and  shake  their  heads  from  side  to  side. 
We  have  seen  clonic  convulsions  followed  by  loss  of  consciousness,  and  in 
some  cases  a  rapid  change  into  tonic  convulsions.  The  muscles  of  masti- 
cation are  especially  affected,  the  jaws  are  clamped,  the  saliva  turned  to 
froth,  the  tongue  may  be  bitten,  and  the  l)lood  turns  the  saliva  red.  Single 
muscle  contractions  follow  one  another  with  astonishing  rapidity,  so 
that  the  saliva  which  lies  in  the  mouth  is  turned  into  foam.  The  convul- 
sions which  are  now  tonic  extend  over  the  whole  muscular  system.     The 


EPILEPSY  257 

body  and  neck  are  drawn  backward  or  sideways;  thei'e  is  twitching  of  the 
ears,  the  legs  are  stretched ;  the  respirations  seem  to  cease.  This  tonic  form 
of  convulsion  lasts  but  a  short  time.  A  few  seconds  after  its  appearance  it 
has  altered  into  clonic  cramps  of  the  muscles,  especially  noticed  in  the  legs, 
which  are  frequently  twitched,  and  the  legs  may  move  rapidly  as  if  the 
animal  was  running.  After  a  few  minutes  these  twitchings  stop;  the  ani- 
mal lies  on  the  ground  for  some  time;  it  finally  rises  and  recovers  very 
quickly;  some  animals,  however,  are  dazed  and  everything  seems  strange, 
they  are  afraid  of  their  owner,  or  do  not  recognize  him.  They  creep 
around  and  hide  in  dark  corners,  and  after  the  attack  has  passed  off  they 
are  greatly  fatigued,  frequently  sleeping  several  hours  at  a  time,  and  in  rare 
instances  show  a  tendency  to  bite.  The  pulse  and  temperature  during 
an  attack  of  this  kind  present  no  alteration  of  any  consequence.  The 
mucous  membranes  of  the  head  are  reddened  and  congested,  sometimes 
cyanotic.  This  is  noticed  at  the  termination  of  an  attack,  and  is  probably 
due  to  the  interruption  of  respiration,  and  the  slight  respiratory  move- 
ments, and  frequently  an  involuntary  passing  of  faeces  and  urine  is  noted 
during  these  convulsions. 

There  are  also  certain  forms  in  which  the  animal  is  restless,  running 
from  side  to  side,  or  having  fainting  spells  (dropping  on  one  side),  slight 
muscular  twitchings  of  the  head  or  extremities,  and  occasionally,  in  mild 
attacks,  a  very  slight  twitching  of  the  jaw,  rolling  or  winking  of  the  eyes. 
The  duration  of  these  attacks  varies,  as  a  rule  not  lasting  very  long, 
generally  only  a  few  minutes,  although  severe  attacks  have  been  known  to 
last  for  five  or  six  hours.  Their  frequency  is  very  uncertain;  some  animals 
have  had  several  attacks  daily,  while  in  others  they  have  appeared  at 
intervals  of  months.  A  peculiar  feature  of  some  cases  of  true  epilepsy 
■was  the  frequent  attacks  on  the  slightest  excitement.  In  the  interval 
between  the  attacks,  the  animal  seems  perfectly  normal,  and  only  in  very 
rare  instances  are  the  animals  subject  to  these  attacks  dull  or  stupid. 
This  disease  is  rarely  fatal  but  an  animal  may  either  injure  itself  during  an 
attack  or  a  very  severe  attack  may  cause  death  by  suppression  of  respira- 
tion or  paralysis  of  the  heart.  The  differential  diagnosis  between  this 
condition  and  a  simple  fit,  or  convulsion,  is  easily  made  on  getting  an 
exact  history  of  the  case. 

In  connection  with  this  disease  we  must  devote  a  few  words  toepilepti- 
form  convulsions  in  young  animals.  We  very  often  see  epilepsy  in  weak, 
debilitated  animals  which  are  backward  or  poorly  fed,  and  which  have 
rickets;  they  also  occur  as  a  consequence  of  reflex  irritability  during  the 
course  of  catarrhal  diseases  of  the  digestive  tract  and  of  the  nasal  cavi- 
ties. We  also  notice  them  after  the  absorption  of  large  quantities  of 
fermenting,  indigestible  food,  in  constipation,  from  the  presence  of  pen- 
tastoma,  and  in  cases  of  intestinal  parasites,  at  the  time  of  teething, 
17 


258  DISEASES  OF  THE  NERVOUS  SYSTEM 

in  acute  affections  of  the  car,  or  parasites  of  that  organ,  and  also  as  a  conse- 
quence of  great  physical  excitement.  We  often  see  spontaneous  convul- 
sions; these  are  very  similar  to  epilepsy,  and  are  probably  of  reflex  origin. 
In  some  of  these  cases  we  may  have  to  deal  with  true  epilepsy,  but,  as  a 
rule,  they  may  be  ascribed  to  an  undeveloped  form  of  distemper,  or  to 
some  poisons,  or  uraemia.  In  some  cases  it  may  be  due  to  some  brain 
affection,  such  as  congestion  of  the  membranes.  It  cannot  be  denied, 
however,  that  there  are  a  great  number  of  convulsive  attacks  for  which 
the  cause  remains  obscure. 

We  may  therefore  conclude  that  we  can  only  obtain  an  approxima- 
tive insight  into  these  convulsions  by  the  symptoms  which  are  presented. 
Frec^uent  occurrence  of  eclamptic  attacks  with  a  short  interval  between 
must  be  considered  as  a  very  serious  symptom. 

Therapeutics. — No  agent  seems  to  have  any  decided  effect  upon 
epilepsy.  The  writer  has  tried  a  number  of  remedies,  one  after  another, 
without  result.  Bromide  of  sodium  seems  to  be  the  best  (this  is  prefer- 
able to  bromide  of  potassium,  as  it  has  no  detrimental  effect  upon  the 
appetite) ,  provided  it  is  given  in  substantial  doses  and  kept  up  for  months. 
With  this  drug  it  is  always  possible  to  prolong  the  interval  between 
attacks;  they  are  also  shortened  and  relatively  less  serious.  Sometimes 
bromide  of  potash,  soda,  and  ammonia  are  administered  together  in  the 
proportion  of  2-2-1  and  seem  to  have  a  more  desirable  effect.  Other 
agents  such  as  oxide  of  zinc,  arsenic,  nitrate  of  silver,  belladonna,  hyoscya- 
mus,  valerian,  bromohydrate,  cold  water,  and  electricity  are  now  rarely 
used. 

The  therapeutic  treatment  during  the  convulsions  consists  in  the  use 
of  applications  of  cold  water  to  the  head;  prevent  the  animal  from  injuring 
itself.  If  one  attack  follows  closely  after  another,  use  inhalations  of 
chloroform,  or  clysters  of  chloral  hydrate;  and  give  internally  large  doses 
of  bromide  of  sodium,  morphia,  or  similiar  sedative  agents,  and  endeavor 
to  keep  the  animal  as  quiet  as  possible  after  the  attack. 

J\.      Bromide  of  sodium,  15.0 

Afiua,  150.0 

S. — One  tablespoouful  three  times  daily. 

In  epileptiform  convulsions  in  young  animals  we  endeavor  to  remove 
the  cause  and  administer  the  salts  of  bromine,  chloral  hydrate,  sulphonal 
(0.5  to  4.0),  hedonal  (1.0  to  4.0),  hypnon  (0.5  to  2.0),  veronal  (0.5  to  1.5). 

I^.      Chloral  hydrate,  5.0 

Mucilage  acacia, 

Syr.  aurcnti  cort.,  aa,  20.0 

Aqua  distillata,  100.0 

F.  M. 
Sig. — A  tablcspoonful  every  two  hours. 


CHOREA  259 

I>.        Hedonal,  12.0 

F.  M.  capsule  ct  divid.  No.  12. 
Sig. — One  daily. 

Chorea. 

(St.   Vitus's  Dance.) 

Etiology. — Chorea  we  no  longer  consider  an  independent  disease,  but 
the  result  of  a  number  of  complications  which  should  really  be  classed 
under  other  heads;  for  instance,  in  young  dogs  that  are  insufficiently  fed, 
or  from  obscure  cerebral  diseases.  It  is  also  seen  in  myelitis,  and  some 
cases  of  symptomatic  chorea,  but  in  the  majority  of  cases  it  must  be 
attributed  to  some  pathological  change  as  a  result  of  distemper. 

In  true  chorea  of  man  we  do  not  see  any  pathological  alterations  of 
the  lirain,  and  in  the  few  cases  which  the  writer  had  to  consider  as  true 
chorea  on  account  of  the  anaemia,  absence  of  any  symptoms  of  distemper, 
or  other  diseases  of  the  brain  and  spine.  The  toxic  effect  of  bacteria 
present  in  the  intestines  has  been  advanced  as  a  possible  cause  by  some, 
but  there  is  little  probability  that  the  convulsions  were  restricted  to  cer- 
tain special  muscular  groups,  and  not,  as  in  human  chorea,  to  irregular 
regions — that  is  to  say,  in  the  various  muscular  centres  of  the  body.  In 
some  of  these  cases  the  animals  were  destroyed,  and  their  post-mortems 
gave  an  entirely  negative  result,  there  being  no  apparent  pathological 
change  in  the  central  nervous  system.  As  a  rule,  the  affected  animals  are 
in  an  ansemic  condition  and  show  all  the  effects  of  bad  nutrition,  and, 
after  some  ol)servation,  we  are  convinced  that  with  improvement  in  the 
general  system  the  choreic  symptoms  become  very  much  lessened. 
Joest  in  the  Zeitschrift  fur  Tiermedizin,  1904,  gives  a  detailed  account  of 
the  disease. 

Clinical  Symptoms  and  Course. — We  define  this  disease  as  a  persistent 
clonic  convulsion  of  some  muscular  group  in  certain  parts  of  the  body. 
For  instance,  we  see  shaking  of  the  head,  twitching  movements  with  one 
or  two  legs,  regular,  and  also  an  automatic  opening  and  closing  of  the 
mouth,  irregular  movements  of  the  tongue,  and  an  undulating  action  or 
movement  of  the  whole  body.  If  the  patients  are  left  to  themselves,  the 
twitching  action  is  generally  less  marked,  and  under  physical  excitement 
becomes  much  more  aggravated;  and  are  also  increasetl  when  eating,  and 
during  catarrhal  conditions  of  the  air-passages,  or  the  intestines,  stomach, 
etc.  The  clonic  movements  lessen  during  sleep  and  under  the  influence 
of  ether,  chloroform,  and  bromo-ether,  but  morphia  and  chloral  have 
little  or  no  influence  upon  them.  The  course  of  this  disease  is  slow,  and 
may  extend  for  months  and  years;  but,  as  a  rule,  the  symptoms  lessen 


260  DISEASES  OF  THE  NERVOUS  SYSTEM 

and  in  very  rare  instances  may  disappear  entirely.  A  fatal  termination 
is  only  to  l)c  feared  when  complications  arise. 

Therapeutics. — The  author  has  tried  all  the  various  agents  recom- 
mended in  this  disease,  but  without  any  decided  results.  Arsenic,  either 
in  the  form  of  Donovan's  or  Fowler's  solution,  or  alternated  with  some 
preparation  of  iron,  has  given  the  best  results.  Schimmel  recommends 
cacodylate,  but  these  di'ugs  must  be  given  for  some  time,  and  it  is  only 
after  prolonged  administration  of  salines  that  any  favoral^le  result  is  ob- 
served. The  writer  thinks  that  more  benefit  is  derived  from  quiet  and 
nutritive  diet,  particularly  meat,  than  anything  else. 

Antipyrine,  which  is  used  in  man,  is  of  not  much  service  in  the  dog. 
Electricity  in  one  case  produced  decided  lessening  of  the  symptoms  after 
regular  application  of  slight  galvanic  stimulation  of  the  head  and  along 
the  vertebral  column. 

Eclampsia. 

Eclampsia,  which  is  not  a  very  good  definition,  is  a  tonic-clonic  con- 
vulsive spasm  which  is  olxserved  in  bitches,  and,  as  a  rule,  during  the 
attacks  the  animal  is  perfectly  conscious. 

Etiology. — The  causes  of  this  disease  are  very  little  known.  Accord- 
ing to  Hertwig  it  ma}'  be  caused  by  cold,  stagnation  of  the  milk  in  the 
udder,  taking  away  the  young  too  soon,  and  sometimes  by  worry.  In 
two-thirds  of  the  cases  of  true  eclampsia  all  the  young  are  still  with  the 
mother,  and  invariably  we  find  the  animals  attacked  to  be  excellent 
mothers,  and  the  litters  are  generally  strong,  and  healthy,  and  lay  on 
flesh  very  quickly  while  the  mother  loses  it.  The  onset  of  the  disease  is 
generally  seen  at  the  end  of  the  second  or  third  week,  but  the  animal  may 
be  dull  and  not  right  for  several  days  before  the  acute  symptoms  show 
themselves.  In  some  cases  observed,  the  disease  developed  after  either 
one  or  more  pups  had  been  taken  away  from  the  mother.  In  the  onset 
of  the  disease  the  mammary  glands  contain  much  milk,  and  the  bitches 
most  frequently  attacked  are  small,  delicate  (house  dogs  and  pet  animals), 
and,  as  a  rule,  have  a  light  coat.  Friedberger  and  Frohner  are  of  the 
opinion  that  the  disease  may  originate  from  anaemia  of  the  spinal  cord  or, 
in  a  reflex  way,  from  the  mammary  glands  and  uterus,  as  they  found 
anaemia  of  the  papilla  of  tlu^  nerve  by  making  an  examination  of  the  retina 
with  the  ophthalmoscope.  Hutyra  and  Marek  state  it  may  also  be  pro- 
duced by  the  direct  action  of  toxines  on  the  sexual  organism  or  on  the 
motor  cells  of  the  antei-ior  horns  of  the  spinal  cord,  and  other  observers 
think  that  there  is  a  similarity  between  this  condition  and  puerperal  fever 
of  the  cow.  With  this  last  theory  the  writer  is  inclined  to  agree.  Accord- 
ing to  the  statements  of  several  authors,  severe  anatomical  disturbances 


ECLAMPSIA  261 

of  the  brain  may  be  caused  directly  from  the  mammary  ghmds.  Fried- 
berger  has  observed  two  bitches  that  had  echimpsia  without  having 
puppies. 

Clinical  Symptoms. — The  disease  may  appear  in  from  forty-eight 
hours  to  thirty  days  after  whelping;  very  rarely  later  than  this  time;  in 
the  majority  of  cases  appearing  at  or  about  four  weeks.  In  one  case  of 
Friedberger's  fifty  days  elapsed.  It  comes  on  suddenly  without  any 
marked  symptoms.  The  aninuils  become  restless  and  anxious;  they  have 
a  staring  expression  of  the  eye,  short,  rapid  respiration,  reddened  mucous 
membranes;  they  show  no  pain  on  pressure  on  the  walls  of  the  chest,  neck, 
or  abdomen.  After  a  short  time  (about  a  quarter  of  an  hour  after  the 
appearance  of  increased  respiration)  they  become  paralyzed,  are  no  longer 
able  to  stand  on  their  feet,  and  remain  for  some  time  with  their  legs 
stretched  from  them.  A  slight  increase  of  temperature  has  been  observed 
in  several  instances  at  the  onset  of  the  disease.  The  dog  lies  on  her  side 
with  her  legs  firm  and  tense;  the  muscles  of  the  body  hard  and  quivering 
to  the  touch;  the  joints  are  stiff  and  hard  to  bend;  and  at  intervals  we  see 
clonic  convulsions  of  all  the  muscles,  especially  those  of  the  extremities, 
and  the  respiratory  muscles  are  especially  involved.  The  respirations 
become  more  rapid  as  a  consequence  of  this,  and  finally  the  mouth  is  opened 
and  the  tongue  protrudes,  while  the  animal  breathes  with  great  difficulty. 
The  pulse  is  small,  firm,  and  sometimes  irregular,  and  always  cpiick;  the 
e3'es  are  staring  and  protruded,  and  there  is  an  anxious  look  in  the  face. 
All  the  visible  mucous  membranes  are  cyanosed.  The  saliva  which  ac- 
cumulates in  the  mouth  is  either  swallowed  convulsively  at  certain  in- 
tervals, or,  as  is  generally  the  case,  it  dribbles  out  of  the  corners  of  the 
mouth.  As  a  rule,  consciousness  is  not  disturbed.  The  pupils  are  normal 
in  size;  reflex  action  is  present.  The  animal  seems  to  notice  external  ob- 
jects or  impressions,  such  as  calling  the  patient,  or  noticing  one  it  knows 
coming  into  the  room.  The  appetite  is  lost;  the  normal  discharges  are  en- 
tirely suppressed;  although  the  urine  and  fseces  may  be  involuntarily 
voided  during  the  attack;  the  urine,  after  such  an  attack,  gives  an  album- 
inous reaction.  The  attack  may  last  for  twenty-four  hours,  but  generally 
varies  a  little  in  intensity.  If  the  attack  is  very  acute,  the  animal  falls 
into  a  deep  comatose  condition  and  dies  in  about  forty-eight  hours  after 
the  onset  of  the  disease  from  apoplexy  and  paralysis,  or  the  cases 
commence  to  recover,  regain  consciousness,  and  frec^uently  make  good 
recoveries. 

Therapeutics. — Taken  in  time  and  treated  energetically  the  animal 
invariably  makes  a  good  recovery.  The  first  thing  to  do  is  to  remove  the 
puppies,  and  either  feed  them  artificially  or  get  a  foster  mother  for  them. 
Any  of  the  narcotics  can  be  used,  and,  as  a  rule,  produce  good  results. 
Give  morphia,  0.002  to  0.  005  gm.  of  the  muriate,  diluted  with  water. 


262  DISEASES  OF  THE  NERVOUS  SYSTEM 

As  a  rule,  a  few  minutes  aftei-  the  hypodermatic  is  administered  the  animal 
becomes  quiet  and  rests  easily.  Inhalations  of  chloroform,  chloral  hydrate, 
bromide  of  potassium,  etc.,  are  also  recommended.  Warm  baths  and 
friction  produce  relaxation  of  the  tense  muscles;  the  ''cold  pack"  is  also 
particularly  useful;  take  a  bed  sheet  or  some  such  large  piece  of  muslin, 
saturate  it  with  cold  water,  wring  it  out  thoroughly  and  wrap  the  animal 
up  in  it,  enclosing  the  whole  body,  of  course,  letting  the  head  free,  allow 
the  animal  to  lie  in  this  for  two  or  three  hours.  Valerianate  of  zinc  in  05. 
gm.  dose  evei'y  two  hours.     Urethane  5  to  20.0.     Hypnon  0.25. 

Divers  Diseases  of  the  Nerves. 

Diseases  of  the  nerves  in  which  there  is  no  anatomical  change. 

Catalepsy. — Catalepsy,  or  "cataleptic  rigidity,"  is  a  rare  disease  in 
which  there  is  a  peculiar  rigidity  of  the  muscles,  and  the  animals  may  l)e 
placed  in  certain  positions  and  remain  perfectly  rigid.  Consciousness  and 
sensitiveness  seem  to  be  suppressed  entirely.  Such  an  attack  lasts  for  hours 
and  recurs  daily,  this  condition  lasting  for  weeks.  The  rigidity  may  start  in 
the  muscles  that  are  in  action  at  the  time  the  animal  is  seized  with  the 
attack,  and  rapidly  extend  to  all  the  muscles  of  the  body,  until  the  animal 
remains  fixed  like  a  statue,  and  may  finally  die  of  starvation,  being  unable 
to  eat  or  drink.  In  many  cases  they  finally  relapse  and  die  in  a  short 
time,  or  they  have  been  known  to  die  in  six  or  seven  days,  or  the  condition 
was  followed  by  general  muscular  weakness,  in  which  the  muscular  walls  of 
the  bladder  and  intestinal  tract  were  also  involved.  There  is  invariably 
subnormal  temperature  and  coma.  If  this  is  really  a  disease,  or  merely  a 
symptom  of  some  br-ain  complication,  the  writer  has  not  been  able  to 
positively  determine. 

Hertwig  mentions  as  causes  of  catalepsy,  cold,  fright,  overloading  the 
stomach  with  indigestible  food,  and  metastases  in  various  diseases. 
Frohner  considers  this  disease  as  a  purely  functional  neurosis  of  the  brain 
and  spine;  he  could  not  find  any  definite  alterations  in  the  central  organs, 
in  catalepsy,  but  he  found  occasionally  certain  secondary  alterations  in 
the  muscles;  namely,  hemorrhages,  dark  venous  swellings,  and  fatty 
degeneration  of  the  muscles,  also  degeneration  of  the  fibres  of  the  heart. 

No  practical  thcrapevitic  treatment  is  known.  Sedatives  such  as  bro- 
mide of  potassium  and  morphine,  electricity  and  cold  douches,  are  used  as 
a  means  of  restoring  the  disturbed  reflex  irritability  of  the  nervous  system. 

Psychosis. — It  is  a  question  whether  psychological  disturbances  can 
occur  in  the  dog  which  has  not  intellectual  elements  of  the  cerebrum 
possessed  by  man,  but  it  is  reasonably  certain  this  question  can  be  an- 
swered in  the  negative.  It  is  evidently  some  disturbance  in  the  sphere  of 
the  will.  In  one  case  of  a  dog  ten  years  old,  the  muscles  affected  were  the 
limbs  and  those  of  mastication.     If  the  animal  had  a  portion  of  food  in  his 


DIVERS  DISEASES  OF  THE  NERVES  203 

month  and  an  attack  came  on,  he  couhl  not  masticate  it,  but  if  it  was  small 
he  would  swallow  it.  The  attack  lasted  about  a  minute  and  during  that 
time  the  animal  kept  his  eyes  half  closed,  and  the  pupils  remained  normal, 
as  was  sensation  and  consciousness.  The  attack  could  be  produced  if  the 
animal  was  struck  on  the  lumbar  region.  Gradually  the  attacks  became 
more  frequent,  until  the  animal  lost  power  of  the  limbs,  became  emaciated 
and  was  finally  destroyed.  Careful  microscopical  examination  of  the 
cerebrum  failed  to  find  any  change  from  normal. 

Convulsions  of  the  Diaphragm,  Convulsive  Hiccough. — A  convulsion 
of  the  diaphragm,  similar  to  hiccough  in  man,  may  be  caused  by  a  central 
or  peripheral  irritation  of  the  phrenic  nerve,  or  by  reflex  irritation  from 
the  digestive  tract.  It  is  rarely  seen  in  the  dog;  in  one  case  the  animal  had 
catarrh  of  the  stomach,  and  the  contractions  of  the  diaphragm  were  the 
same  in  number  as  the  heart  beats,  certain  muscles  of  the  head,  neck,  and 
extremities  were  also  affected.  The  treatment  consisted  in  the  sub- 
cutaneous administration  0.01  of  morphia,  if  the  convulsion  continues 
over  any  length  of  time,  but  as  a  rule,  the  attack  lasts  only  from  fifteen 
to  thirty  minutes. 

Basedow's  Disease. — A  disease  similar  to  that  found  in  man,  has 
been  observed  several  times  in  the  dog.  The  three  following  symptoms 
are  characteristic:  Exopthalmus  (staring  or  bull's  eye),  tachycardia 
(palpitation  and  acceleration  of  the  pulse)  and  struma  (enlargement  of 
the  thyroid  gland,  with  an  altered  secretion  of  that  organ).  It  must  be 
regarded  as  a  general  neurosis.  In  an  animal  not  quite  a  year  old,  the 
eyes  protruded  from  the  orbit,  movement  of  the  eyelid  (lowering  and  eleva- 
tion) was  absent;  the  patient  was  restless,  moving  from  place  to  place,  the 
pulsations  were  130  and  the  respirations  30  to  35.  The  pulsations  of  the 
heart  could  be  easily  felt  through  the  thorax.  The  appetite  was  irregular. 
The  animal  had  quite  a  large,  goitre.  After  being  treated  eight  days  the 
animal  was  destroyed.  The  brain  was  anaemic  and  the  thyroid  gland 
was  greatly  increased  in  volume  and  there  were  three  secondary  glands, 
and  the  right  ventricle  of  the  heart  was  greatly  dilated. 

Treatment  of  this  disease,  which  is  generally  chronic,  consists  in  rest, 
the  animal  must  be  kept  aw^ay  from  any  excitement  given  food  of  a  nour- 
ishing and  substantial  kind,  and  must  be  easily  digestible.  Administer 
iodide  of  potassium,  bromide  of  potassium  or  iodide  of  sodium.  In  one 
case  in  an  old  pug  dog,  the  animal  made  a  good  recovery  after  four  months 
treatment.  Iodine  in  the  form  of  tincture  of  iodine  by  inunction,  has 
given  good  results  in  some  cases.  Iron  preparations.  Fowler's  solution, 
thryoid  serum  or  rodagen,  both  prepaired  in  animals  that  have  had  the 
cultivated  serums  of  the  thyroid  gland,  injected  intravenously.  If  this 
method  of  treatment  does  not  produce  results  either  remove  the  enlarged 
thyroid  (struma)  or  ligate  the  thyroid  arteries. 


264  DISEASES  OF  THE  NERVOUS  SYSTEM 

Cachexia  Strumipriva. — When  the  thyroid  gland  is  removed,  there 
appear  certain  pathological  phenomena  that  are  the  opposite  to  Basedow's 
disease.  In  two  or  three  days  after  removal  of  the  gland,  sometimes  a 
later  period,  the  extremities  become  stiff,  clonic  muscular  twitching  and 
convulsive  movements  of  the  muscles  of  mastication  are  seen  with  trem- 
bling, dyspnoea,  acceleration  of  the  heart,  stupor,  albumen  in  the  urine, 
emaciation  and  death  in  al)out  a  month.  In  cases  where  only  one-half 
of  the  gland  was  removed,  there  is  no  systemic  disturbance,  and  the  same 
occurs  if  there  should  be  secondary  thyroid  glands  which  perform  the  func- 
tions of  the  extirpated  gland.  It  is  possible  to  prevent  a  fatal  termina- 
tion by  injecting  the  animal  with  thyroid  preparations,  or  administering 
the  preparation  internally. 

Bronchocele,  Hypertrophy  of  the  Thyroid  Gland,  Goitre,  Struma. 

As  Morbus  basedowii  and  Cachexia  strumipriva  belong  to  the  group 
of  true  diseases  of  the  nerves,  and  Goitre  has  so  many  characteristics  in 
common  with  these  diseases,  it,  will  be  classed  with  them.  Goitre  is  a 
chronic  hypertrophy  of  the  thyroid  gland.  It  may  either  be  a  simple  hy- 
perplasia of  the  gland  (struma  simplex,  struma  parenchymatosa,  struma 
f  ollicularis)  or  it  may  be  more  or  less  of  a  cystoid  degeneration  with  the 
formation  of  cavernous  cysts,  filled  with  gelatinous  contents  (struma 
cystica)  or  it  may  be  of  a  fibrous  character,  united  by  connective  tissue 
(struma  fibrosa) ,  or  an  enlargement  of  the  veins  (struma  vasculosa,  struma 
varicosa)  or  finally  we  may  have  a  carcinomatous  or  even  sarcomatous  de- 
generation of  the  gland  (struma  maligna).  One  observer  found  ossifica- 
tion of  the  gland  (struma  ossea).  In  young  dogs  when  the  first  named 
condition,  simple  hyperplasia,  is  found  to  be  soft,  it  is  termed  struma 
mollis,  and  it  is  said  to  be  congenital,  while  in  older  dogs  we  more  fre- 
Cjuently  find  the  hard  fibrous  goitre  and  the  struma  carcinomata.  In 
Switzerland  30  to  40  per  cent,  of  all  dogs  over  middle  age  are  affected 
with  goitre,  and  generally  of  the  cancerous  type.  Goitrous  degeneration 
generally  involves  the  whole  gland,  but  in  fibrous  or  the  malignant  types 
■\ve  frequently  find  only  one-half  is  affected,  or  may  be  unequally  distributed 
over  both  halves  of  the  gland.  Malignant  forms  frequently  involve  not 
only  the  gland  but  also  the  surrounding  tissues,  affecting  the  lungs,  called 
struma  aberrans.  In  two  such  cases,  the  enlargement  was  in  the  mediasti- 
num in  one,  and  in  the  other,  in  the  middle  third  of  the  neck.  These  growths 
Avhich  originated  from  the  secondary  thyroid  were  cancerous  in  structure. 

Etiology  and  Clinical  Symptoms. — The  true  cause  or  origin  of  goitre 
has  not  as  yet  been  defined:  In  man,  horses  and  cattle,  it  is  supposed  to 
be  due  to  the  effect  of  mountains  and  the  absence  of  sun  in  deep  valleys,  or 
to  the  soil  (rich  in  calcium  and  magnesia,  and  the  absence  of  the  iodides), 
but  in  the  dog  this  cause  can  hardly  be  said  to  hold  good,  as  in  canines,  it 


BRONCHOCELE,  GOITRE,  STRUMA 


265 


occurs  in  all  countries  and  conditions,  and  appears  where  goitre  in  other 
species  is  extremely  rare.  One  observer  is  inclined  to  think  it  is  caused  by 
the  straining  of  a  collar  in  harness,  or  to  any  active  exercise;  chronic 
heart  disease  seems  to  have  some  bearing  on  the  disease,  but  why,  has  not 
up  to  the  present  time  been  definitely  stated.  Without  a  doubt,  heredity 
is  a  predisposing  cause  (struma  congenita).  Young  animals  have  propor- 
tionately a  very  large  thyroid  and  it  becomes  reduced  gradually  as  the 
animal  grows  older,  but  occasionally  the  opposite  occurs,  and  instead  of 
growing  less  it  gradually  increases. 

Goitre  is  very  easily  recognized,  directly  below  the  larynx  on  both 
sides  of  the  trachea.     It  is  painless,  there  is  no  local  increase  in  tempera- 


&Ps<--V.^ 


Fig.  98. — Malignant  struma. 


ture,  it  may  be  hard  or  soft,  sometimes  irregular,  sometimes  as  large  as 
a  closed  fist,  and  in  extremely  large  ones  from  its  weight  it  hangs  down 
from  the  throat.  If  the  goitre  is  very  large  it  may  interfere  to  a  certain 
extent  with  deglutition.  In  cystic  goitre  the  cysts  can  be  easily  distin- 
guished on  manipulation.  The  malignant  forms  are  frequently  uneven, 
irregular  and  nodulated,  and  vary  in  consistence  (Fig.  98).- 

Treatment. — It  is  either  medicinal  or  operative.  Medicinal  treat- 
ment is  only  useful  in  the  parenchymatous  or  cystic  goitre,  the  latter  only 
when  it  is  not  too  far  advanced  and  consists  in  the  administration  of 
iodine  either  internally  in  the  form  of  iodide  of  potassium,  or  iodide  of 
sodium  in  moderate  do.ses,  (0.1),  or  friction  externally,  iodine  or  iodide  of 
potassium  ointment,  oleates  of  iodine,  or  Lugol's  solution  of  iodine.     In 


266  DISEASES  OP  THE  NERVOUS  SYSTEM 

one  case  a  10  per  cent,  solution  of  papayotin  (vegetable  pepsin)  was  in- 
jected into  the  tumor  and  in  forty-eight  hours  the  digested  parenchyma 
of  the  gland  was  aspirated  in  the  form  of  a  milk-like  liciuid.  The  inter- 
parenchymatous  injection  of  Lugol's  solution  of  iodine  are  rather 
dangerous,  but  the  writer  has  found  a  solution  of  iodoform  1.0  in  ether 
and  olive  oil  7.0  much  better. 

Recently,  preparations  have  been  made  from  the  thyroid  gland  of 
cows,  thyroidin  tablets  (Merck) ,  thyradin  taljlets  (Knoll) ;  these  tablets  are 
prepared  commercially,  each  tablet  contains  0.3  of  normal  thyroid  gland, 
and  we  give  1  to  3  tablets  daily.  In  weak  animals  at  first  give  the  smallest 
dose  and  carefully  watch  the  animal.  In  the  administration  of  too  large 
doses  you  may  have  all  the  symptoms  of  Basedow's  disease.  Frequently, 
when  the  treatment  is  continued  for  some  time  and  with  favorable  results, 
if  the  treatment  is  stopped,  immediately  the  gland  commences  to  enlarge 
again. 

When  medicinal  ti'eatment  has  no  results,  or  the  struma  is  malignant, 
surgical  treatment  is  necessary.  In  cystic  goitre  that  is  well  developed, 
it  can  be  opened,  drained  and  filled  with  iodoform  gauze.  The  malig- 
nant and  fibrous  goitre  must  be  removed,  but  it  must  always  be  remem- 
bered that  entire  removal  of  the  gland  generally  causes  death  in  a  short 
time  (see  Cachexia  strumipriva).  Only  one-half  of  the  gland  must  be 
removed,  and  in  a  case  of  bilateral,  the  one  that  is  affected  the  more,  as 
it  is  a  question  if  iodothyrin  or  any  of  the  thyroid  preparations  will  arrest 
cachexia  strumipriva,  if  it  follows  removal  of  the  gland.  On  account  of 
great  vessels,  recurrent  nerve  etc.,  in  the  neighborhood  of  goitre,  the 
operation  must  be  classed  as  one  of  the  most  dangerous  operations  in 
the  dog. 

Inflammation  of  the  Thyroid  Gland.  Thyroiditis,  Struma  Acute. — This 
condition  is  extremely  rare,  and  is  generally  of  traumatic  origin  (bites, 
gunshot  wounds,  etc.).  It  forms  large  c{uantities  of  pus.  This  condi- 
tion must  not  be  confounded  with  those  enlargements  of  the  thyroid  that 
occur  in  young  dogs  and  are  the  result  of  catarrh  of  the  larynx  and 
pharynx.  The  periodical  swelling  of  the  thyroid  that  is  seen  in  very  young 
dogs,  that  swells  and  in  a  few  days  returns  to  normal  size,  is  not  in  any  way 
related  to  thyroiditis.  The  treatment  of  inflammation  of  the  thyroid 
gland  is  to  treat  it  as  a  surgical  wound. 


DISEASES  OF  TRUE  INFECTION. 


Distemper  and  Contagious  Catarrhal  Fever. 

The  definition  of  the  word  ''distemper"  describes  a  disease  which  is 
peculiar  to  the  canine  race,  and  it  is  caused  by  a  specific  poison  which 
finds  its  way  into  the  system,  as  a  rule,  through  the  lungs  and  air-pas- 
sages. It  generally  attacks  young  animals  and  runs  its  course  as  a 
catarrhal  fever,  affecting  all  the  mucous  membranes  of  the  body,  and  is 
almost  invariably  accompanied  with  certain  nervous  symptoms,  and 
pustular  skin  eruptions. 

Etiology. — Distemper  is  a  disease  which  is  contagious  in  the  highest 
degree,  and  is  only  communicated  by  infection.  It  does  not  seem  to  have 
been  recognized  or  described  by  the  ancients  or  the  writers  of  the  middle 
ages.  An  animal  aflfectecl  with  distemper  can  remain  but  a  short  time  in 
any  locality  and  affect  every  animal  there,  or  it  may  be  transmitted  from 
a  person  or  object  that  has  been  in  contact  with  an  affected  animal.  As  a 
rule,  few  young  animals  escape  distemper,  generally  contracting  it  before 
they  are  a  year  old,  and  dogs  over  that  age  very  rarely  take  the  disease. 
That,  however,  may  be  accounted  for  from  the  fact  that  dogs  having 
arrived  at  that  age  have  either  come  in  contact  with,  the  disease  previous 
to  that  and  they  have  had  it  in  a  mild  form,  or  the  system  was  in  such  a 
condition,  that  they  did  not  contract  it.  The  disease  affects  animals  but 
once  during  life,  although  a  few  exceptions  are  presented  where  animals 
have  contracted  it  a  second  time.  As  a  rule,  delicate,  weak,  poorly-fed 
animals  (vegetable  diet),  or  animals  which  have  been  affected  by  some 
catarrhal  disorder  of  the  respiratory  mucous  membranes,  contr!ict  the 
disease  in  its  acute  form;  while,  on  the  other  hand,  dogs  which  have  lots  of 
exercise,  especially  animals  in  the  country  or  small  cities,  are  mildly 
affected  with  the  disease,  and  the  rate  of  mortality  is  much  less. 

Distemper  exists  in  all  countries  of  the  world.  In  the  large  cities  it  is 
found  at  any  season  of  the  year,  while  in  the  country  it  is  generally  more 
prevalent  during  the  warm  weather.  The  specific  poison  of  distemper  is 
not  definitely  known.  It  is  undoubtedly  a  fixed  and  volatile  virus* 
which  enters  the  system  by  the  mouth  and  nose,  and  it  exerts  its  first 

*By  a  "  fixed  and  volatile  virus"  we  understand  a  fixed  virus  that  when  secreted  in  the 
lungs,  is  carried  out  in  fine  division,  in  the  particles  of  moisture  in  the  expired  air,  and  easily- 
held  in  suspension  in  an  atmosphere  that  contains  a  slight  quantity  of  humidity. 

267 


268  DISEASES  OF  TRUE  INFECTION 

influence  on  the  res})iratorv  passages.  Vaccination  of  young  animals  l)y 
means  of  the  mucous  secretions  from  animals  affected  with  the  disease 
has  been  tried,  and,  as  a  rule,  reproduces  the  disease. 

Semmer  believes  that  he  has  definitely  defined  the  contagious  germ  in 
the  blood,  and  also  found  it  in  the  lungs,  liver,  and  spleen,  in  the  form  of 
small,  dagger-shaped  microbes,  which  he  calls  the  "bacilli  of  distemper." 
Rabe  has  found  in  the  secretion  of  the  nose  and  connective  tissue,  also  in 
the  blood,  small  cocci,  which  accumulate  in  heaps,  or  were  connected 
together  in  small  groups  of  three  or  four  in  a  line,  or  they  may  hang  to- 
gether like  a  string  of  beads.  These  he  considers  the  specific  conta- 
gious matter  of  distemper;  but  Friedberger  does  not  agree  with  this 
theory.  Mathis  found  in  the  contents  of  the  pustule  a  diplococcus  which 
could  be  colored  with  fuchsin.  He  used  bouillon  cultures  of  this  diplo- 
coccus for  the  inoculation  of  ten  dogs.  These  dogs  were  affected  by 
symptoms  which  resembled  very  closely  those  of  distemper.  Marcone 
and  Meloni  found  a  micrococcus  in  a  dog  which  was  affected  by  distem- 
per, and  considered  that  this  was  the  true  pathogenic  agent,  as  it 
produced  the  skin  eruptions,  broncho-pneumonia,  and  gastro-enteritis 
in  dogs  which  had  been  inoculated  with  pure  cultures.  Legrain  and 
Jafjuet  obtained  pure  cultures  of  micrococci,  Avhen  held  in  certain  media, 
from  fluid  obtained  from  the  pustules  in  the  exanthema  of  distemper. 
These  were  gathered  together  in  the  form  of  diplococci  and  chains.  In 
dogs  vaccinated  with  these  cultures  only  the  skin  eruption,  with  the 
development  of  pustules,  was  seen,  but  the  subjects  so  treated  seemed  to 
enjoy  immunity  from  the  disease.  Millais  made  cultures  from  the  nasal 
excretion  of  the  dogs  affected  by  distemper  upon  gelatinous  media,  of  two 
different  bacilli,  which  mixed  together,  on  inoculation,  produced  distem- 
per. Galli-Valerio  has  isolated  ovoid  bacilli,  1.25-2.5/t.  in  length,  which 
grows  freely  in  gelatin.  These  he  found  in  abundance  in  the  lungs  and 
central  nervous  system,  but  did  not  find  them  in  the  blood.  The  inocula- 
tion of  the  cultivations  produced  characteristic  distemper  in  puppies,  but 
did  not  give  the  same  results  in  adult  dogs.  Jensen  is  of  the  opinion  that 
the  pneumonia  of  distemper  is  caused  by  a  streptococcus,  but  he  has  found 
in  the  bronchial  mucous  membranes  other  bacteria,  particularly  the  bac- 
terium coli.  Babes  and  Bazanesco,  in  two  cases  isolated  from  the  lung, 
liver  and  blood,  found  a  very  fine  short  motile  bacillus,  about  0.3  to 
0.4/i.  long.  Nine  young  dogs  were  inoculated  and  seven  died  in  from 
ten  to  eighteen  dayc  of  typical  distemper,  and  the  various  oi'gans  con- 
tained the  bacilli  inoculated.  Zelinski,  Xeucki,  and  Karapinski,  maintain 
they  are  positive  distemper  is  communicable  to  man,  and  give  as  the 
mediary  cause  a  microorganism  similar  to  the  white  staphylococcus  of 
Resenbach,  but  differing  from  the  same  in  its  bio-chemical  properties. 
Taty  and  Jaccjuine  have  found  in  the  spine  and  cord  of  a  dog  that  died 


DISTEMPER  AND  CONTAGIOUS  CATARRHAL  FEVER  2G9 

of  nervous  distemper  a  peculiar  diplococcus  to  which  they  ascribe  import- 
ant pathogenic  action.  Jess  cultivated  a  bacillus,  found  in  the  conjunc- 
tival, nasal  and  other  mucous  membranes  and  organs  of  the  body,  which 
was  1.3//.  long  and  0.6u.  wdde.  Injections  of  the  culture  were  made  both 
intraperitoneally  and  subcutaneously;  three  or  four  days  afterwards  a 
fever  appeared  which  was  accompanied  by  great  flow  of  tears,  and  diar- 
rhcea,  and  in  the  vicinity  of  the  inoculated  spot  there  appeared  isolated 
red  spots.  Petropawloski  found,  in  all  cases  of  distemper,  a  bacillus  which 
resembled  that  described  by  Galli-Valeris,  and  also  that  described  by 
Babes  and  Barzanesco  but  differed  from  the  first  by  its  negative  action  to 
Gram's  coloring  method  and,  from  the  latter  by  its  easy  cultivation  on 
potato.  j\Iari  thinks  that  the  baccilli  of  Petropowlowsky  as  well  as  those 
of  Schantyro  are  in  all  probability  coli-bacilli  and  really  not  related  in  any 
way  etiologically  to  the  baccilli  of  distemper.  Casol  claims  to  have 
found  a  micrococcus,  which  is  both  isolated  and  in  groups,  and  claims  it  is 
colored  by  Gram's  method.  From  these  he  made  pure  cultivations  and 
transmitted  it  successfully.  Lignieres  places  distemper  among  the 
hemorrhagic  septicaemias  and  calls  it  Pasteurellosis  canum,  and  is  due  to 
a  particularly  virulent  bi-polar  bacillus  (Pasteurella  canis).  Trasbot,  on 
the  other  hand,  thinks  that  the  microorganism  cultivated  by  Lignieres  is  a 
pneumo-inciter  and  only  produces  the  secondary  phenomena  in  the  disease 
and  is  not  the  original  cause  of  the  development  of  the  disease.  Wunsch- 
heim  has  isolated  a  short  rod,  very  similar  to  the  bacteria  of  chicken 
cholera.  Piorkowski  found  in  the  spleen  and  lung  a  small  staff  bacillus,  the 
cultivations  of  which  when  inoculated,  developed  the  disease  and  death 
in  two  or  three  w^eeks.  Ceramicola  cultivated  an  ovoid  polymorphus 
taken  from  dogs  which  had  died,  particularly  of  virulent  distemper,  and 
the  bacteria  possessed  all  the  morphological  properties  of  the  inciter  of 
hemorrhagic  septicaemia,  and  the  animal  inoculated  died  with  all  the 
characteristics  of  true  distemper.  Carre  is  of  the  opinion  that  none  of 
the  organisms  visible  to  the  microscope  can  be  considered  the  exciters  of 
distemper  in  the  dog;  he  took  nasal  mucus  from  an  infected  dog,  passed 
it  through  a  filter,  the  filtrate  when  spread  on  different  nutritive  media 
remained  sterile,  and  the  defibrinated  blood  of  an  animal  inoculated  with 
the  filtrate  produced  fever  of  the  nostril  and  pustules.  This  blood  was 
also  spread  on  various  nutritive  media  and  also  remained  sterile.  Cadiot 
and  Breton  and  others  are  of  the  opinion  that  in  distemper  there  is  an 
ultra-microscopical  organism  which  can  be  filtered,  and  with  this  microbe 
there  is  also  a  microorganism  which  may  have  some  influence  on  the  course 
of  the  disease  (foetid  bacillus  and  Pasteurella  canis). 

Direct  vaccinating  methods  have  been  practised  by  various  practi- 
tioners. For  instance,  Trasbot  transferred  secretions  from  the  nose  and 
pustules  of  animals  affected  with  the  disease,  by  means  of  a  number  of 


270  DISEASES  OF  TRUE  INFECTION 

small  incisions  in  the  abdominal  wall  of  healthy  young  animals.     The 
disease  appeared  after  eight  days. 

Krajewski  vaccinated  numerous  young  animals  with  secretions  of 
the  nose  and  pustules,  these  inoculations  being  on  the  mucous  mem- 
brane of  the  nose,  and  under  the  skin,  and  arrived  at  the  following 
conclusions: 

1.  The  contagious  germ  of  distemper  is  confined  to  the  secretion  of 
the  nose  and  eyes,  and  the  blood. 

2.  The  germ  does  not  lose  its  virulent  properties  in  any  degree  when 
dried  at  a  normal  temperature,  or  frozen  at  18°  to  20°  of  cold.  However, 
its  virulence  becomes  attenuated  when  kept  for  any  length  of  time  in  a  dry 
place. 

3.  The  disease,  when  it  is  produced  by  vaccinating,  runs  a  very  mild 
course,  and  kills,  as  a  rule,  from  10  to  15  per  cent,  while  the  ordinary 
disease  kills  from  32  to  70  per  cent.  Laosson  has  obtained  the  same  results 
after  vaccinating  ninety-eight  animals,  and  found  also  that  the  contents 
of  these  pustules  are  generally  inactive,  and  that  the  nasal  secretion 
loses  its  virulence  after  eight  days.  Friedberger's  observations  are  dia- 
metrically opposite,  for  he  contends  that  he  has  caused  infection  by  means 
of  the  contents  of  the  pustules.  He  also  recognized  in  cases  where  the 
disease  originated  from  vaccination  that  there  was  a  short  intervening 
stage  of  incubation  and,  as  a  rule,  was  much  less  in  intensity,  ran  a  veiy 
rapid  course,  and  that  the  groups  of  pustules  were  confined  to  the  region 
of  vaccination. 

Schantyr  has  lately  published  certain  observations  concerning  the 
microbes  of  distemper.  He  agrees  with  Putz  that  distemper  of  the  dog 
resembles  distemper  in  horses  to  a  remarkable  degree,  and  his  theory  of 
the  subject  is  that  distemper  may  be  classified  into  three  diseases,  accord- 
ing to  the  presence  of  three  microorganisms  of  different  characters. 
These  diseases  are:  Abdominal  typhus,  true  distemper  of  the  dog, 
and  canine  typhoid.  Their  clinical  as  well  as  their  pathological 
symptoms  have  a  great  similarity  with  one  another,  and  it  is  only 
with  a  careful  microscopical  examination  that  the  specific  microorgan- 
isms can  be  separated.  The  bacilli  of  typhoid  (small,  slender  bacilli, 
which  are  almost  exactly  like  the  typhoid  bacilli  in  man)  are  generally 
found  separate  in  the  blood,  while  the  bacilli  of  distemper  (small,  and 
somewhat  curved)  and  the  bacilli  of  typhoid  (typhoid  are  very  small  and 
slender)  are  generally  arranged  in  groups.  The  bacilli  of  typhus  are  hard 
to  color  with  fuchsin,  and  become  colorless  with  Gram's  test.  This  is 
not  the  case  with  distemper  and  the  bacillus  of  typhoid.  Typhus  and 
typhoid  bacilli  give  characteristic  cultures  upon  agar,  gelatin,  and  potato, 
while  the  bacillus  of  distemper  is  extremely  hard  to  cultivate  under  any 
circumstances.     Megnin  divides  distemper  into  two  groups.     Cadiot  and 


DISTEMPER  AND  CONTAGIOUS  CATARRHAL  FEVER  271 

Breton  describe  another  contagious  broncho-pneumonia,  but  present  no 
pustular  rash,  probably  In'ing  infectious  bronchial  catarrh. 

Clinical  Symptoms  and  Course. — The  stage  of  incubation  of  distemper 
is  generally  from  four  to  seven  days.  In  rare  cases  it  may  linger,  for 
eight  to  twelve  days,  after  contact  with  the  diseased  animal,  and 
Krajewski  states  that  cases  of  infection  through  cohabitation  may  some- 
times take  from  two  to  two  and  a  half  weeks  to  develop.  The  first  actual 
symptom  is  an  increase  of  temperature.  In  the  initial  stage  it  rises  to  40°, 
and  in  some  cases  41°  and  over.  An  increase  in  temperature  has  been  oIj- 
served  by  the  writer  in  all  cases  of  distemper,  when  the  examination  was 
made  early  in  the  disease.  Later  on  the  temperature  falls  slightly,  but  in 
some  cases  very  rapidly,  and  it  may  even  go  below  the  normal  point,  ac- 
cording to  the  individuality  of  the  anmial,  and  to  the  intensity  of  the  at- 
tack. Yery  mild  cases  have  little  or  no  elevation  of  temperature,  but  as  a 
rule  there  is  a  regular  increase  and  decrease  of  temperature,  as  the  disease 
runs  its  course.  In  fatal  cases  toward  the  end  the  temperature  is  invari- 
abl}-  subnormal.  In  cases  developed  by  inoculation  we  occasionally  find  a 
marked  increase  in  temperature.  The  next  symptom  is  the  disturbance 
of  the  general  condition.  The  animal  is  depressed,  restless,  has  little  or 
no  appetite,  seeks  the  heat,  becomes  easily  fatigued,  is  chilly  and  shivering, 
the  nose  is  hot  and  dr}^  the  skin  is  inelastic,  and  the  hair  becomes  harsh 
and  dry,  the  animal  refuses  to  play  or  to  go  out  for  a  walk,  lies  most  of 
the  time  and  gets  into  dark  places.  In  some  instances  vomiting  occurs, 
but  can  hardly  be  called  a  characteristic,  initital  symptom  of  the  disease. 
This  stage  of  the  disease  is  short,  from  24  to  48  hours;  the  symptoms  in- 
crease rapidly,  and  develop  the  four  characteristic  forms,  which  are  as 
follows: 

1.  Catarrhal  distemper  (eyes  and  nose  and  lungs),  muco-purulent 
discharge  of  the  nose  and  eyes,  cough,  which  is  very  persistent  and  may  be 
so  severe  as  to  cause  great  depression  or  vomiting,  more  or  less  increase  of 
respiration,  which  in  some  cases  may  be  labored. 

2.  Gastric  distemper  (intestinal  distemper),  coated  tongue,  loss  of 
appetite,  thirst,  vomiting  mucous  in  thick  tenacious  masses,  diarrhoea, 
yellow  in  color  and  fseces  that  are  muco-purulent,  and  may  even  contain 
blood. 

3.  Nervous  distemper  (irritation  of  the  brain  and  spinal  cord). 
Fear,  uneasiness,  great  irritability,  dulness  or  sleepiness,  twitching  of  the 
muscles  of  mastication,  or  epileptiform  convulsions,  chorea  and  complete 
paralysis. 

4.  Exanthematical  distemper  (distemper  pustuia,  dog  pox),  pustules 
on  the  abdomen  and  internal  surface  of  thigh. 

The  following  phenomena  of  distemper  may  appear  during  the  course 
of  the  disease: 


272  DISEASES  OF  TRUE  INFECTION 

1.  Symptoms  on  the  External  Membranes. — These  appear  in  the  ma- 
jority of  cases  and  are  of  great  importance  in  diagnosis.  We  see  a  number 
of  small  red  spots  upon  the  inner  fascia  of  the  thighs,  the  abdomen  and,  in 
rare  instances,  the  mouth  and  eyes,  on  the  internal  surface  of  the  ear  flap 
or  even  on  the  vestibule,  and  still  more  rarely  covering  the  entire  body. 
They  are  generally  scattered,  very  rarely  confluent.  They  rapidly  form 
small  bladder-like  blisters  filled  with  serum,  and  later  on  this  serum 
changes  to  pus.  They  are  about  the  size  of  a  lentil  or  small  bean,  and 
soon  dry  up,  forming  yellowish  scabs  and  crusts.  When  the  eruption  is 
very  extensive,  the  animal  gives  off  a  very  unpleasant  odor  from  the 
affected  parts.  These  pustules  are  rarely  itchy,  and  if  so,  it  is  only  to  a 
very  slight  degree.  After  these  scabs  fall  off  (generally  in  about  one 
week) ,  they  leave  a  red  circular  spot  on  the  skin  which  disappears  slowly. 
In  other  cases  we  find  more  or  less  depth  to  the  cicatrix,  leaving  pit-like 
ulcerations.  They  are  probably  due  to  the  animal  scratching  or  gnawing 
the  sore.  In  rare  cases  the  rash  has  appeared  on  the  lips,  extended  over 
on  the  mucous  membrane  and  caused  extensive  ulcerative  processes  of 
the  mouth  or  it  may  spread  all  over  the  body  and  in  occasional  cases  it 
is  found  in  the  prepuce  causing  purulent  catarrh  of  that  organ.  This  is 
the  only  skin  eruption  that  characterizes  this  disease  and  it  dries  up  very 
quickly,  so  that  in  from  eight  to  fourteen  days  we  see  no  other  marks 
except  those  light,  granulating  spots  (exanthema  of  distemper,  distemper 
pox).  Hertwig  and  Friedberger  have  observed  some  cases  in  which  this 
eruption  made  its  appearance  without  any  other  symptom  of  distemper. 

2,  Symptoms  Indicated  by  the  Eyes. — There  is  generally  more  or  less 
purulent  catarrhal  conjunctivitis.  The  animal  avoids  the  light.  There 
is  redness  and  swelling  of  the  conjunctiva.  In  the  early  stages  the  secre- 
tion is  serous  and  very  fluid.  Later  on  it  becomes  a  muco-purulent  se- 
cretion, either  light  gray  or  yellowish  in  color.  This  sometimes  occurs  in 
large  masses  (blennorrhoea  of  the  eyes).  This  fluid  collects  in  the  corner 
of  the  lower  eyelid  or  trickles  down  over  the  face,  drying  in  yellowish 
crusts  in  the  edges  and  borders  of  the  eyelids,  frec|uently  gluing  them  to- 
gether. The  corrosive  action  of  these  secretions,  and  also  the  inflamma- 
tion of  the  surrounding  membranes,  may  cause  lesions  of  the  cornea,  some- 
times from  the  animal  scratching  and  rubbing  the  eye,  especially  in  ani- 
mals with  prominent  eyes  (such  as  pugs  and  King  Charles  spaniels).  In 
some  cases  it  may  be  due  to  deficient  nutrition  of  the  cornea.  This 
ulceration  starts  with  a  slight  swelling  on  the  external  surface  of  the 
cornea  and  the  subsecjuent  formation  of  an  ulceration.  (Other  details 
will  be  found  in  the  chapter  on  Diseases  of  the  Eye) . 

We  see  cases  where  there  is  a  deep  pericorneal  injection  of  the  cornea,  (ker- 
atitis parenchymatosa),  in  which  a  blue  grey,  blue  white,  or  milky  white 
opacity  commences  at  the  outside  edge  of  the  cornea  and  spreads  over  its  en- 


DISTEMPER  AND  CONTAGIOUS  CATARRHAL  FEVER  273 

tire  surface.  It  may  affect  one  or  both  eyes  at  the  same  time,  and  the  opac- 
ity may  disappear  leaving  no  trace  or  it  may  go  away  slowly  and  in  rare 
cases  leave  permanent  white  star-like  spots  on  the  surface  of  the  cornea.  In 
rare  cases  keratitis  parenchymatosa  and  some  fever  may  be  the  only 
symptoms  observed  during  the  course  of  the  disease  The  ulcerations  are 
apt  to  appear  in  the  middle  or  most  prominent  part  of  the  cornea,  and  pene- 
trate into  the  corneal  tissue,  and  the  pit-like  depression  on  the  cornea  may 
become  vascular,  and  it  may  also  perforate  the  cornea,  evacuate  the  con- 
tents of  the  anterior  chamber,  cause  prolapse  of  the  iris,  and  formation  of 
staphyloma.  Loss  of  the  eye,  by  purulent  panophthalmitis,  is  very  rare, 
the  eye  clearing  up  and  leaving  more  or  less  pigmentation  of  the  cornea. 
Diseases  of  the  interior  of  the  eye,  by  extension  of  the  inflammation 
of  the  cornea,  are  very  rare  in  distemper.  This  may  be  complicated 
with  a  permanent  opacity  of  the  sclerotic  membrane,  and  in  rare  cases  the 
whole  eye  becomes  acutely  inflamed  and  breaks  down  (see  Diseases  of 
the  Eye). 

3.  Symptoms  of  the  Respiratory  Apparatus. — These  are  generally  a 
catarrhal  inflammation  of  the  mucous  membranes  of  the  upper  air  pass- 
ages, and,  if  the  disease  is  acute,  the  finer  sections  of  the  bronchi  become 
inflamed.  The  first  symptom  is  a  catarrh  of  the  nose,  which  is  marked 
by  sneezing  and  the  animal  rubbing  or  wiping  his  nose  with  his  front  paws. 
This  discharge  increases.  In  the  early  stages  it  is  simply  serous;  later  it 
becomes  mucous,  grayish-white  or  grayish-yellow,  sometimes  bloody,  and 
in  some  cases  even  purulent,  with  more  or  less  odor.  We  also  see  a  "  snift"- 
ling"  respiration.  This  is  particularly  noticeable  in  short-headed  dogs 
(such  as  pugs  or  bulldogs) .  In  all  cases  there  is  catarrh  of  the  larynx,  and 
bronchioles.  Catarrh  of  the  larynx  is  generally  marked  by  a  loud, 
hoarse,  dry  cough,  which  is  particularly  distressing  to  the  animal,  especi- 
ally at  night.  As  the  disease  advances  it  becomes  moist  and  looser,  and  is 
easily  produced  by  a  slight  pressure  on  the  larynx.  Where  there  is 
simple  laryngitis,  we  do  not  generally  see  any  visible  increase  or  difficulty 
in  respiration.  This  is  changed,  however,  as  soon  as  the  large  bronchial 
tubes  become  involved.  In  such  cases  we  see  a  marked  increase  in  res- 
piration, wdiich  gradually  becomes  more  intense  as  the  inflammatory  pro- 
cess goes  downward  into  the  finer  bronchi.  Any  pressure  on  the  sides  or 
tapping  upon  the  walls  of  the  chest  causes  a  very  distinct,  painful,  dis- 
tressing cough.  On  auscultation  we  hear  an  increased  vesicular  breath- 
ing, as  well  as  dry  and  moist  rattling  bruits,  which  are  of  various  forms 
and  intensity. 

If  the  inflammatory  process  has  extended  to  the  fine  bronchi  it  is 
not  rare  to  see  the  formation  of  lobular  pneumonic  centres — that  is  to  say, 
catarrhal  pneumonia.  Difficulty  in  respiration  now  appears  more  pro- 
nounced; respiration  is  superficial  but  laborious,  as  is  proved  by  the  infla- 
18 


274  DISEASES  OF  TRUE  INFECTION 

tion  of  the  cheeks.  The  number  of  respirations  may  increase  from  GO  to 
80  or  even  more.  The  cough  is  very  painful,  dull,  and  weak;  the  pulse  is 
greatly  increased,  and  the  temperature  may  increase  to  a  marked  degree, 
but  it  is  remittent.  On  ausculting  we  hear  in  the  lungs,  snoring,  groan- 
ing, and  wheezing  sounds  and  rattling  bruits  (these  last  are  moist  and 
numerous),  also  more  or  less  blowing  sounds  in  different  regions.  We 
notice  an  increased  vesicular  respiration  with  sharp,  prolonged,  expir- 
atory bruits,  of  a  mixed  character.  In  the  same  region  we  may  notice 
bronchial  respiration.     Percussion,  as  a  rule,  is  not  very  instructive. 

4.  Symptoms  of  the  Digestive  Tract. — The  chief  of  these  is  catarrh  of 
the  stomach,  which  may  vary  in  intensity.  There  is  entire  loss  of  appetite, 
vomiting  of  a  thin,  frothy,  turbid  lic{uid  Avhich  is  shiny  or  muco-puru- 
lent.  There  are  frecpient  discharges  from  the  bowels  of  a  thin,  muco- 
purulent fluid,  occasionally  streaked  with  blood,  and  always  accompanied 
by  a  painful  tenesmus.  We  may  also  find  the  abdomen  very  painful  on 
pressure,  and,  as  a  rule,  contracted  and  tense.  Yellow  coloration  of  the 
visible  mucous  membranes  (icterus)  is  occasionally  observed. 

5.  Symptoms  of  the  Nervous  System. — The  animal  is  very  dull,  espe- 
cially its  senses.  There  is  a  marked  apathy  and  depression,  and  in  some 
cases  deep  coma.  In  a  great  many  cases  this  condition  may  be  accom- 
panied by  periods  of  excitement,  nervousness,  great  restlessness,  and  even 
true  delirium.  These  periods,  which  might  possibly  be  mistaken  for  rab- 
ies, are  not  of  any  great  length,  as  a  rule,  the  animal  sooner  or  later  show- 
ing signs  of  marked  depression.  Motor  disturbances,  such  as  twitching  of 
various  groups  of  muscles,  mostly  the  head  and  extremities,  are  noticed, 
and,  in  some  cases,  convulsions  or  true  eclamptic  attacks.  These  follow 
one  another  at  long  intervals,  or  keep  the  animal  irritated  for  days. 
Clonic  convulsions  of  the  maxillary  muscles  are  very  frec{uently  seen. 
They  consist  of  a  rapid  and  regular  twitching  of  the  muscles  of  the  lower 
jaw,  sometimes  confined  only  to  chattering  of  the  teeth,  and  occasionally 
sufficiently  strong  to  make  a  foam  of  the  saliva.  Besides  this,  we  may  see 
symptoms  of  motor  paralysis.  The  patients  are  unsteady  and  irregular 
in  their  actions.  In  some  instances  they  drag  their  hind  legs,  or  occa- 
sionally their  posterior  extremities  lose  their  power  and  the  animal  is  un- 
able to  stand;  in  rare  instances,  due  to  paralysis  of  the  sympathetic,  the 
bladder  and  the  lower  bowel  lose  the  power  of  their  sphincters  and  urine 
and  fgeces  are  evacuated  involuntarily. 

Other  General  Symptoms. — As  has  already  been  observed,  the  tem- 
perature may  rise  or  fall,  and  follow  an  irregular  course,  and  it  is  apt  to  be 
subnormal  in  the  majority  of  fatal  cases.  When  bronchitis  increases  in 
intensity  and  a  catarrhal  pneumonia  develops,  it  is  apt  to  be  accompanied 
by  considerable  increase  in  temperature.  In  some  cases,  due  to  paren- 
chymatous degeneration  of  the  cardiac  muscle,  the  pulse  is  small,  thready 


DISTEMPER  AND  COXTAGIOUS  CATARRHAL  FEVER 


2/0 


and  irregular.  The  urine  frequently  contains  more  or  less  bile  coloring 
matter,  sometimes  albumin  and  tube  casts  are  found.  In  some  cases  the 
general  nutrition  and  condition  may*  keep  up  well  all  during  the  disease  and 
in  other  cases  the  animal  at  the  onset  of  the  disease  rapidly  loses  his  vital 
force,  even  when  it  is  eating  a  fair  amount  of  nutriment,  goes  down  in 
strength  each  day.  Frequently  the  expired  air  has  a  particularly 
unpleasant  penetrating  odor. 

The  anatomical  alterations  of  the  nervous  system,  produced  by  this 
disease,  which  are  shown  in  the  section  of  the  brain,  are  sometimes  very 
slight,  and  it  is  rather  remarkable  to  find  such  acute  nervous  symptoms 
with  so  little  pathological  alterations.  The  microscopical  examination 
shows  little  change,  or  few  alterations  you  might  expect  from  many  of 
the  infectious  diseases  of  other  animals.  We  must,  therefore,  admit  that 
the  microbes  of  distemper  are  not  as  yet  well  known.  Like  all  other  path- 
ogenic micro  organisms,  they  prodvice  "ptomaines."  It  has  been  proven 
that  the  severity  of  the  nervous  symptoms  depends  to  a  certain  extent 
upon  the  natural  disposition  of  the  animals,  and  also  their  bodily  health. 
When  they  take  the  disease,  as  weak,  anaemic,  poorly  fed  animals,  they 
are  very  apt  to  be  severely  attacked  with  a  nervous  form  of  the  disease. 
Occasionally  symptoms  appear  in  this  disease  which  should  be  mentioned, 
such  as  serious  weakness  of  the  heart.  This  may  be  due  to  a  parenchyma- 
tous degeneration  of  the  heart  muscle.  It  is  generally  fatal,  as  it 
produces  oedema  of  the  lungs.  Albuminuria  is  produced  by  paren- 
chymatous degeneration  of  the  kidneys,  and  in  rare  instances  from  true 
nephritis;  decubitus  is  seen  occasionally  in  severe  cases  in  the  elbow- 
and  knee-joints,  also  at  the  femoro-tibial  articulation.  This  sometimes 
causes  septicaemia  and  produces  death. 

The  large  number  of  the  above-described  symptoms  show  how  com- 
pletely the  whole  body  may  be  affected  with  this  disease;  generally,  how- 
ever, the  gastri-catarrhal  forms  predominate  and  run  a  regular  course. 
We  also  observe  in  some  instances  peculiarities  and  symptoms  which  may, 
to  a  large  extent,  come  from  a  general  want  of  nutrition,  or  want  of  resist- 
ance in  some  cases,  while  in  others,  especially  in  the  terrier  classes,  they 
seem  to  be  able  to  throw  off  the  disease  and  stand  more  acute  attacks  than 
other  animals.  There  are  some  forms  of  the  disease  which  are  so  mild  in 
character  as  to  almost  escape  observation.  Thus  we  may  have  a  mild 
exanthema  or  a  slight  respiratory  or  intestinal  catarrh  which  may  be 
difficult  to  recognize.  The  duration  of  this  mild  form  of  the  disease  may 
be  from  half  to  one  week.  Of  the  different  forms  of  the  disease  the  catar- 
rhal and  gastric  forms  are  most  frequently  seen,  the  nervous  next,  and  the 
exanthema  least.- 

Coui-se  and  Prognosis. — Distemper  generally  runs  its  course  in  two  or 
three  weeks,  although  we  occasionally  see  cases  where  the  disease  is,  as  we 


276  DISEASES  OF  TRUE  INFECTION 

have  just  stated,  particularly  mild  which  runs  its  course  in  one  week  to  a 
week  and  a  half,  and  in  severe  cases  is  prolonged  for  a  much  longer  period. 
In  such  cases  this  prolongation  is  not  due  to  the  influence  of  the  disease 
directly,  but  rather  to  secondary  complications.  We  may  count  among 
these,  certain  nervous  diseases  which  frequently  remain  or  appear  after 
the  disease  has  run  its  course.  For  instance,  paralysis  of  some  of  the  mus- 
cles, of  the  hind-quarters,  or  of  all  the  extremities,  and  rhythmic  move- 
ments resembling  St.  Vitus's  dance  in  some  of  the  muscular  groups, 
especially  the  muscles  of  the  face  or  of  the  legs,  and  is  indicated  by  a  con- 
stant twitching,  clonic  in  character,  sometimes  severer  at  one  time  than 
another,  but  more  especially  after  excitement.  Blindness,  loss  of  sense 
of  smell,  or  bark  may  also  result  from  alteration  of  the  nerves;  or  the  an- 
imal becomes  an  idiot,  has  hallucinations  (thirion),  difficulty  in  respira- 
tion, persistent  anaemia,  and  a  chronic  catarrh.  Amaurosis  and  deafness 
may  occur  in  some  cases. 

Prognosis. — The  prognosis  of  distemper,  as  a  rule,  should  be  regarded 
as  unfavorable  even  in  those  cases  which  are  apparently  mild,  for  in  this 
disease  the  symptoms  may  change  in  one  day,  from  the  mildest  to  the 
most  acute.  Of  course,  the  danger  of  the  disease  increases  with  the  in- 
tensity of  the  nervous  symptoms,  and  especially  if  the  symptoms  are  pro- 
longed, and  with  them  a  persistent  high  temperature,  and  even  in  cases 
where  we  have  a  subnormal  temperature.  Another  series  of  cases  which 
must  be  regarded  as  unfavorable  are  those  which  are  in  their  course  com- 
plicated by  serious  nervous  symptoms  or  by  symptoms  of  catarrhal  pneu- 
monia. Young  dogs  which  are  delicate  (especially  when  not  fed  on  meat) 
anaemic,  or  rachitic,  will  succumb  to  the  disease  sooner  and,  as  a  rule, 
present  severer  symptoms  than  those  which  have  been  fed  with  meat  and 
have  had  plenty  of  open-air  exercise.  A  marked  decrease  of  temperature, 
without  a  similar  improvement  in  the  general  condition,  is  always  to  be 
looked  upon  as  an  extremely  serious  symptom.  Death  may  occur  in  two 
ways:  through  paralysis  of  the  brain  or  oedema  of  the  lungs,  and  occasion- 
ally from  septictemia  or  from  general  exhaustion.  From  the  experience 
of  the  writer,  the  death-rate  is  from  20  to  30  per  cent.  It  depends  to  a 
great  extent  whether  there  are  a  number  of  cases  together  or  solitary  cases 
— in  the  former  the  percentage  is  much  higher;  but  at  the  same  time  it  is 
impossible  to  give  any  positive  statistics,  because  in  cities  the  death-rate 
is  much  higher,  and  in  small  towns  and  in  the  country,  where  distem- 
per runs  a  comparatively  mild  course,  the  death-rate  is  much  smaller. 
The  writer  finds  that  in  a  large  city  the  death-rate  amounts  to  60  to  70  per 
cent. 

Pathological  Anatomy. — The  most  prominent  and  constant  anatom- 
ical alterations  found  at  post-mortem  are  those  in  the  respiratory  and 
digestive  organs.     In  the  former  there  are  all  the  phenomena  of  an  acute 


DISTEMPER  AND  CONTAGIOUS  CATARRHAL  FEVER  277 

catarrhal  inflammation  of  the  Larynx,  trachea  and  bronchi,  and  also  of 
lobular  pneumonia  and  catarrhal  inflammation  of  the  stomach  and  intes- 
tines.    For  details,  see  under  their  respective  chapters. 

We  find  also  more  or  less  pathological  alteration  in  the  central  ner- 
vous system,  such  as  hypersemia  and  small  hemorrhages  in  the  coverings  of 
the  brain;  cedema  of  the  brain  is  sometimes  present  with  flattening  of  the 
convolutions  and  serous  infiltration  into  the  subarachnoids.  In  the  ven- 
tricles and  base  of  the  skull  we  have  more  or  less  marked  venous  hyper- 
semia. As  a  rule,  the  spinal  cord  shows  nothing  abnormal  except  that  it 
is  pale  and  seems  soft  in  consistence. 

Under  the  miscroscope  decided  changes  have  been  noticed  in  the 
brain.  Kolesnikoff  detected  an  infiltration  of  brain-matter  and  walls 
of  the  brain  vessels  with  lymphoid  cells  as  well  as  a  distention  of  the 
capillaries  and  smaller  arteries.  These  were  filled  with  red  and  white 
blood  corpuscles.  In  the  infiltrated  walls  of  the  vessels  of  the  brain  were 
found  dark-colored,  homogeneous  granulations  and  accumulations. 
Krajew^ski  found  also  the  perivascular  spaces  and  the  ganglionic  cells 
filled  with  lymphoid  corpuscles,  and  he  mentions  particularly  that  those 
cases  had  died  without  showing  any  prominent  nervous  symptoms. 
Muzulewitsch  found  inflammation  of  the  spinal  cord  in  acute  nervous 
distemper,  in  which  there  w^as  marked  hypersemia.  He  also  found  al- 
terations in  the  walls  of  the  vessels,  and  an  albuminous  exudation  in  the 
upper  third  part  of  the  spinal  cord  along  the  blood  vessels,  as  well  as  in 
the  interstitial  tissue  of  the  gray  substance.  As  a  sequence  of  the  acute 
nervous  form  we  have  a  chronic  interstitial  myelitis  with  partial  atrophy 
of  the  spinal  cord. 

Carougeau  found  an  infiltration  of  leucocytes  in  the  gray  matter  of 
the  entire  cord,  particularly  in  the  anterior  horns,  a  myelitis  disseminate 
which  he  believes  was  originated  by  the  toxic  action  of  distemper  contagio- 
sum ;  this  observation  was  made  on  a  dog  affected  with  chorea  as  a  sequence 
of  distemper.  Bohl  and  Rexter  have  reached  the  same  conclusion  from 
their  observations  of  the  central  nervous  systems  of  dogs  affected  with 
distemper. 

Other  abnormal  conditions  are  found  in  distemper,  such  as  anaemia, 
parenchymatous  or  fatty  degeneration  of  the  heart,  liver,  kidneys,  and 
an  abnormal  swelling  of  the  lymphatic  glands  and  changes  in  the  skin 
and  eyes. 

Prophylaxis. — The  animal  affected  with  the  disease  should  be  kept 
away  from  all  animals  that  have  not  already  had  the  disease,  j^articularly 
young  animals;  strict  disinfection  of  the  kennels  or  sleeping  places  of  the 
affected  animals  and  also  the  various  articles  used  by  them.  Prevent- 
ive vaccination,  while  it  cannot  be  called  a  success,  is  worth  considera- 
tion.    Dogs  that  are  not  too  highly  bred,  but  bred  on  rational  lines,  and 


278  DISEASES  OF  TRUE  INFECTION 

are  well  kept  and  substantially  fed,  are  better  al^le  to  stand  the  disease 
and,  after  it  has  run  its  course,  come  out  of  it  stronger  and  make  quicdc 
I'ecoveries;  it  cannot  be  said,  however,  that  in  this  disease  this  always 
holds  good,  for  frequently  an  animal  that  is  in  perfect  health  and  fine 
physical  shape  may  contract  the  disease  and  die,  and  another  animal  in 
not  nearly  so  good  condition  throws  off  the  disease  and  makes  a  very 
c|uick  and  prompt  recovery. 

Preventive  Vaccination. — In  the  last  century  numerous  attempts 
have  been  made  to  find  some  inoculating  material  which  would  produce 
immunity  to  distemper,  either  entire  immunity  or  at  least  for  a  certain 
period,  and  the  results  of  certain  observers  have  been  mentioned  already, 
notably  Krayewski.  Ligniere,  who  considers  distemper  should  be  classed 
among  the  hemorrhagic  septicaemias,  recommends  a  serum  which  he 
prepares  and  calls  polyvalent  immune  serum.  Phisalix  vaccinates  with 
greatly  diluted  cultures  of  the  bacilli  of  distemper.  The  immunizing 
action  of  the  vaccine  has  been  confirmed  by  Grey,  Spiccr,  Howtakcr, 
who  claim  that  this  vaccine  when  injected  into  the  animal  at  the  time 
it  is  affected  with  the  disease  has  to  a  certain  extent  the  property 
of  lessening  both  the  intensity  and  course  of  the  disease.  Ligniere, 
Jewell,  Hobday,  Parker  and  a  committee  appointed  in  England  to  test 
this  vaccine  obtained  unfavorable  results.  An  immunizing  agent  called 
antidistemper  serum,  prepared  by  the  Jenner  Institute  of  London,  has 
been  sold  commercially.  Meyer,  who  has  used  a  large  quantity  of  the 
serum,  reports  that  after  the  animal  is  vaccinated  it  produces  a  mild  form 
of  distemper  which  is  catarrhal  in  form,  and  after  the  acute  symptoms 
disappear  there  may  be  nervous  del)ility,  unstead}-  g'^it,  and  in  one 
case  the  animal  became  deaf.  The  vaccinated  dogs,  when  brought  in 
contact  afterward  with  dogs  affected  with  acute  distemper,  either  did 
not  contract  it  at  all  or  they  had  a  very  mild  attack.  This  serum  in- 
jected into  an  animal  affected  by  distemper  seems  to  have  in  certain 
cases  a  decided  beneficial  effect. 

An  antidistemper  serum  prepared  by  the  bacteriological  insti- 
tute of  Piorkowski  in  Berlin,  does  not  seem  to  produce  the  results 
claimed  for  it.  This  serum  is  recommended  not  only  for  immunization 
(5  to  10  c.c.  is  injected  subcutaneously  in  any  part  of  the  bod}',  the  best 
location  being  the  neck)  but  also  for  curing  the  disease  (in  doses  of  20 
to  50  c.c),  and  according  to  the  statement  of  Piorkowski  85  per  cent,  of 
animals  having  both  catarrhal  and  nervous  forms  are  cured. 

Baden  used  a  large  quantity  of  this  serum  and  came  to  the  conclu- 
sion that  in  some  cases  it  produced  very  good  results,  but  these  were 
generally  in  the  mild  catarrhal  gastric  forms  and  when  the  treatment 
was  commenced  immediately  after  the  onset  of  the  disease.  In  moi-e 
acute  cases  when  the  disease  had  gone  on  for  some  time,  and  there  were 


DISTEMPER  AND  CONTAGIOUS  CATARRHAL  FEVER  279 

either  convulsions  or  chronic  twitchings  or  catarrhal  diarrhtea,  the  injec- 
tion of  the  serum  produced  no  effect  whatever. 

Wagner  and  Pinkammer  declare  it  is  valueless,  while  Lange  and 
Creutz  claim  to  have  had  very  good  results  when  used  in  the  early  stages 
of  the  disease.  Opinions  are  also  divided  in  regard  to  other  serums, 
for  instance  that  of  Gans,  as  well  as  what  is  known  as  Dutchman's  serum, 
obtained  from  animals  fed  with  yeast.  This  latter  serum  is  used  only  as 
a  therapeutic  agent;  some  observers  claim  good  results  from  it. 

Numerous  tests  have  been  made  by  the  writer,  but  it  cannot  be  said 
positively  that  the  results  are  such  as  to  say  the  serums  are  of  any  prac- 
tical value,  and  when  we  consider  that  up  to  the  present  time  the  active 
agent  in  the  production  of  the  disease  has  not  been  definitely  isolated,  or 
its  actual  nature  and  structure  known,  we  can  hardly  cultivate  a  serum 
to    combat  it. 

Some  of  the  agents  mentioned  as  being  specific  for  distemper  are 
Gurnine  (ganglionary  serum)  which  has  not  been  found  to  produce  any 
beneficial  results.  Yeast  and  yeast  preparations,  furonculine  (dis- 
temper antigurmine,  creolin,  etc.) ,  seem  to  have  some  influence  in  control- 
ling intestinal  catarrh.  Calomel  has  also  a  certain  effect  in  the  early 
stages  of  gastric  distemper.  Creolin  inhalations  are  good  in  pulmonary 
and  bronchial  forms  of  distemper,  as  also  inhalations  of  benzoin  and 
balsam  of  Peru.  Trichloride  of  iodine  which  Ellerman,  de  Brun  and 
others  injected  subcutaneously,  3  to  5  cm.  in  a  solution  of  1  to  100,  has 
a  very  favorable  influence  when  administered  in  the  early  stages  of  the 
disease,  but  in  the  more  advanced  stages  of  the  disease  it  has  little  or  no 
influence.  Ichthargan  in  3  per  cent,  solution,  iodipin,  tallianine,  1  to 
5  cm.  intravenouvsly. 

Therapeutics. — No  special  therapeutic  treatment  can  be  given  for  dis- 
temper— that  is,  no  agent  has  been  found  up  to  this  time  which  has  the 
property  of  destroying  or  rendering  harmless  the  specific  micro-organisms 
present  in  this  disease.  Certain  antiseptic  and  antibacterial  remedies, 
like  quinine,  salicylic  acid,  antipyrine,  etc.,  may  generally  reduce  the 
fever,  but  they  produce  no  influence  on  the  general  course  of  the  disease. 
The  use  of  agents  for  reducing  the  temperature  is  objectionable,  as  they 
not  only  deprive  us  of  the  symptom  of  temperature,  which  is  of  the  great- 
est importance  during  the  course  of  the  disease,  but  cause  more  or  less 
depression  of  the  heart.  According  to  Frohner's  experiments,  calomel 
is  supposed  to  have  a  slight  claim  as  a  universal  agent,  but  this  is  on  the 
same  order  as  black  coffee,  which  was  formerly  advocated  by  Trasbot. 
Common  salt  has  been  recommended  by  Zippelius,  and  ergotin  was 
highly  recommended  and  frequently  used  a  few  years  ago.  None  of 
these  remedies,  while  they  prove  beneficial  in  some  cases,  is  to  be  laid 
down  as  a  specific  for  the  treatment  of  the  disease,  therefore  we  must 


280  DISEASES  OF  TRUE  INFECTION 

continue  to  treat  it  in  a  purely  symptomatic  manner.  Antipyrine,  which 
was  advocated  as  an  absolute  specific,  does  not  in  the  least  deserve  this 
recommendation.  The  diet  must  be  easily  digested  food,  but  at  the  same 
time  as  nutritious  as  possible.  Milk,  bouillon,  soup,  and  scraped  raw 
meat  (which  is  generally  taken  with  a  relish)  have  much  to  commend 
them.  In  grave  cases  where  there  is  entire  loss  of  appetite,  we  must  use 
concentrated  food,  such  as  peptonized  meat,  extract  of  beef,  and  clear 
broth.  This  may  be  given  with  some  mild  alcoholic  stimulant,  wine,  etc. 
There  are  some  forms  of  extract  of  beef  which  are  not  to  be  recommended, 
on  account  of  their  slight  nutritive  value  and  as  they  also  contain  a 
large  proportion  of  sodium  salts.  When  the  temperature  rises  above 
40°  we  must  try  to  reduce  it  by  means  of  frictions  of  alcohol  and  mild 
antiseptics. 

The  "antipyretic''  treatment  can  only  be  used  in  rare  instances  in 
the  dog.  The  chief  medicinal  agents  are  quinine,  salicylate  of  sodium, 
antifebrine,  and  antipyrine.  The  older  remedies  (digitalis,  veratrum,  etc.) 
have  been  abandoned  for  some  time  on  account  of  their  direct  action  on 
the  heart.  This  is  also  the  case  with  kairin,  thallin,  and  phenacetin. 
The  writer,  as  a  rule,  does  not  advise  the  use  of  Cj[uinine  on  account  of 
its  action  upon  the  heart. 

It  must  be  said,  however,  that  in  this  disease  good  nursing,  attention 
to  dietetics,  fresh  air  and  cleanliness  are  the  greatest  factors  in  producing 
good  results.  The  animal  must  be  kept  in  a  dry,  clean,  warm  (not  hot) 
well  lighted  and  ventilated  kennel,  but  avoid  the  slightest  suspicion  of  a 
draught  or  dampness,  and  to  prevent  the  spread  of  the  disease  through 
contagion,  disinfect  the  place  when  the  animal  has  recovered,  as  well  as 
the  surroundings  used  by  the  animal  from  time  to  time.  The  food  should 
be  substantial  and  easily  digested,  such  as  milk,  sago,  egg  and  milk, 
mutton  broth  and  eggs,  thick  soups  and  small  quantities  of  raw  meat 
must  be  given  at  short  intervals. 

When  the  animal  refuses  to  eat,  he  must  be  given  food  in  concentrated 
form,  such  as  thick  meat  broth,  with  a  yolk  of  egg  in  it,  extract  of  meat, 
extract  of  malt,  hamatogenc,  hsemo-albumen,  or  use  some  of  the  various 
extracts  of  beef. 

To  maintain  the  strength,  or  when  the  acute  symptoms  have  sub- 
sided but  the  animal  is  weak,  the  digestion  poor,  or  the  mouth  sore  and 
solid  particles  of  food  cannot  be  eaten,  we  use  concentrated  food,  such  as 
some  of  the  various  meat  extracts  and  peptonized  products,  commercial 
meat  juice  and  liquified  peptone;  nutritive  preparations  containing 
albumen,  such  as  samatose,  plasmon,  etc.  If  the  stomach  cannot  retain 
food  but  is  vomited  up  immediately  after  it  is  given,  nutrition  can  be 
administered  by  means  of  clysters.  This  can  be  meat  broth,  yolks  of 
egg,  and  thick  starch  water,  to  make  it  of  enough  consistency  to  be 


DISTEMPER  AND  CONTAGIOUS  CATARRHAL  FEVER  281 

retained  in  the  rectum.  Very  frequently  by  this  means  an  animal  can 
be  carried  over  the  grave  stages  of  the  disease,  and  it  is  surprising  how 
long  an  animal's  life  can  be  sustained  by  this  means.  Albrecht  mentions 
one  dog  that  had  chronic  nephritis,  and  was  nourished  for  forty-two  days 
by  this  means.  In  the  administration  of  a  nutritive  clyster,  the  rectum 
must  be  first  cleansed  by  an  injection  of  luke-warm  water,  and  in  about 
ten  minutes,  not  sooner,  the  nourishing  clyster  is  given;  the  amount 
varies  from  a  tablespoonful  to  a  cupful,  according  to  the  size  of  the  animal. 
The  injection  must  be  made  slowly  and  carefully,  care  being  taken  not  to 
excite  the  animal  any  more  than  is  necessary,  and  when  the  nozzle  of 
the  injection  pipe  is  withdrawn  the  anal  opening  must  be  held  closed 
for  a  short  time,  and,  if  possible,  elevate  the  hind  cjuarters  of  the 
animal. 

The  following  nutritive  clysters  are  recommended: 

1.  Two  or  three  beaten  up  eggs,  250.0  thick  bouillon. 

2.  Two  beaten  up  eggs,  200.0  concentrated  bouillon  and  a  spoonful  of 
starch. 

3.  Two  beaten  eggs,  10.0  peptonoids,  120.0  sherry  wine,  250.0 
bouillon. 

4.  One  beaten  egg,  600.0  bouillon,  150.0  port  wine,  0.5  bicarbonate  of 
soda,  0.02  common  salt,  and  60.0  peptonoids. 

5.  Two  beaten  eggs,  4.0  salt,  20.0  port  wine,  250.0  milk. 

6.  Two  or  three  eggs  beaten  up  with  a  little  cold  water,  and  a  pinch 
of  starch;  these  are  laid  to  one  side,  then  a  tablespoonful  of  sugar,  a  half 
cup  of  milk  and  a  wineglassful  of  port  wine  are  mixed  together  and  boiled 
for  a  short  time,  when  it  is  allowed  to  cool.  When  it  is  nearly  cold  add  the 
combination  to  it  with  a  small  pinch  of  salt,  care  being  taken  to  see  that 
the  solution  is  not  warm  enough  to  coagulate  the  milk. 

In  the  early  stages  of  the  disease,  the  stomach  can  be  emptied  by 
means  of  an  emetic,  such  as  the  subcutaneous  injections  of  apomorphia, 
antimonial  wine,  etc.  It  is  a  ciuestion  whether  an  emetic  by  its  subse- 
cjuent  depression  does  not  do  more  harm  than  good.  As  a  rule,  constipa- 
tion is  not  present  and  the  bowels  had  better  be  left  alone;  if  the  animal 
commences  to  eat  and  the  intestinal  canal  returns  to  its  normal  condition, 
the  lower  bowel  will  be  emptied  naturally  without  the  assistance  of  drugs; 
if,  however,  it  is  necessary  to  evacuate  the  rectum,  use  a  glycerine  sup- 
pository. 

Other  therapeutic  measures  will  have  to  be  employed  as  the  symptoms 
arise,  and  we  would  refer  you  to  the  diseases  of  the  nose,  larynx,  bron- 
chia, and  air-passages,  also  to  those  of  the  stomach  and  intestine,  par- 
ticularly where  there  is  persistent  diarrhoea,  and  lastly  diseases  of  the 
brain,  spinal  cord,  and  eyes.  As  a  rule,  no  treatment  should  be  used  for 
the  skin  eruption  in  distemper.     If  any  irregularity  arise,  however,  this 


282  DISEASES  OF  TRUE  INFECTION 

may  be  treated  according  to  the  methods  recommended  under  Diseases 
of  the  Skin. 

Conjunctivitis  is  general!}'  treated  by  a  solution  of  sulphate  of  zinc 
(1  to  100),  or  painting  the  diseased  membranes  with  a  solution  of  nitrate 
of  silver  (1  to  70).  This  must  be  followed  afterward  by  a  1  per  cent,  so- 
lution of  chloride  of  sodium.  "  Blennorrhoea  of  the  eyes"  should  be 
treated  by  bathing  the  parts  with  some  antiseptic  solution,  such  as  creolin 
(1  to  100),  corrosive  sublimate  (1  to  2000),  or  boric  acid  (1  to  40),  or  by 
painting  the  mucous  memlirane  by  means  of  a  camel's  hair  pencil  with  a  2 
per  cent,  solution  of  sulphate  of  copper.  Ulceration  of  th^  cornea  should  be 
treated  with  a  3  or  4  per  cent,  solution  of  boric  acid.  Parenchymatous 
keratitis  may  be  treated  with  a  few  drops  of  a  1  to  100  solution  of  atropine. 
After  the  acute  inflammatory  symptoms  of  the  eye  have  subsided  blowing 
calomel  directly  on  the  cornea  produces  good  results. 

Infectious  Bronchial  Catarrh. 

(False  or  Bench-show  Disteinj)cr.) 

Within  the  last  twenty  years  bench  shows  have  become  very  numer- 
ous, and  kennels  both  large  and  small  ai-e  legion,  and  from  each  kennel  one 
to  ten  or  more  of  the  dogs  are  being  exhibited  from  time  to  time,  we 
freciuently  observe  in  these  kennels  shortly  after  dogs  return  from  the 
shows  a  disease  that  resembles  and  is  frecjuently  taken  for  distemper. 
This  disease  for  a  better  name  has  been  called  "  Bench-shoAV  Distemper." 
It  is  decidedly  infectious  and  attacks  the  large  bronchi  producing  catarrhal 
bronchitis  and  a  muco-purulent  discharge  from  the  nostrils  and  eyes; 
with  this  there  is  also  catarrh  of  the  intestines.  The  writer  has  also  felt 
that  there  may  possibly  }:)e  such  a  condition,  and  has  intimated  that  fact 
under  the  head  of  Catarrh  of  the  Bronchia  (page  137). 

Etiology. — It  is  generally  seen  in  large  kennels,  attacking  one  animal 
after  another  or  several  at  once.  It  may  also  be  o])served  where  several 
dogs  have  been  sent  to  a  bench  show,  developing  shortly  after  they  return. 
The  period  of  inculjation  is  three  to  five  days.  Another  peculiarity  is  that 
one  attack  does  not  insure  immunity  from  another.  The  writer  has  ob- 
served several  dogs  that  have  developed  this  disease,  and  the  next  year 
repeated  the  attack  after  returning  from  a  show. 

Pathological  Anatomy. — The  lesions  found  are  very  similar  to  those 
of  true  distemper,  but  milder  in  character.  The  alterations  in  the  lungs 
are  those  of  catarrhal  i)neumonia.  The  most  frequent  condition  oljserved 
is  great  irritation  of  the  nnicous  membrane  of  the  intestines,  with  more  or 
less  swelling  of  the  whole  intestinal  tract.  The  follicles  and  glands  of  the 
intestines  may  be  swollen  or  enlarged,  and  in  rare  instances  ulcerated,  but 
not  to  the  marked  degree  seen  in  distempei'. 


INFECTIOUS  HEMORRHAGIC  GASTROENTERITIS  283 

Clinical  Symptoms. — The  animal  is  dull  and  listless  for  two  days, 
when  the  temperature  will  be  found  to  be  39°  or  40°;  slight  running  fi-om 
the  eyes;  and  invariably  diarrhtea.  This  last  symptom  is  generally  olv 
served  from  the  first,  the  stools  being  liciuid  the  first  few  days,  and  later 
filled  with  gelatinous  mucus.  At  the  end  of  a  week  there  way  be  some 
passed  in  the  stools,  but  this  is  not  commonly  seen. 

The  appetite  may  be  very  poor  or  even  lost,  but  generally  in  three  or 
four  days  the  animal  will  commence  to  eat,  but  stop  again  if  the  diarrha-a 
should  be  severe,  or  eat  very  small  quantities.  Vomiting  is  rarely  seen 
except  at  the  onset. 

The  discharge  from  the  nose  and  eyes  is  difficult  to  distinguish  from 
distemper,  except  that  it  is  thinner  and  muco-purulent.  The  cough  is 
stronger,  and  not  the  soft,  shallow  cough  observed  in  distemper.  Fre- 
quently we  find  acute  laryngitis  or  bronchitis.  The  exanthema  of  dis- 
temper is  absent  but  the  hair  is  dry  and  harsh,  and  freciuently  the  hair 
falls  out  very  rapidly  in  the  long-coated  dogs,  especially  collies. 

The  mouth  very  frequently  becomes  sore  and  the  gums  may  ulcerate. 
In  rare  cases  a  series  of  aphthous  ulcers  are  seen  on  the  lips  and  around  the 
free  end  of  the  tongue.  This  condition  rarely  causes  death  unless  the 
diarrhoea  is  persistent  and  the  animal  will  not  eat;  and  any  attempt  at 
forced  feeding  is  folloAved  by  vomiting. 

In  some  cases  shortly  after  the  acute  symptoms  commence  there  may 
be  evidences  of  congestion  of  the  brain,  accompanied  by  severe  and  con- 
tinued convulsions,  which  frequently  cause  death. 

The  treatment  is  practically  the  same  as  in  distemper.  Keep  the  ani- 
mals warm  and  dr};,  give  easily  digested  food,  lean  meat,  carefully  remov- 
ing all  fat,  and  quinine,  iron,  and  some  of  the  pepsin  preparations,  and 
allow  them  to  run  if  they  are  not  too  weak.  Penning  them  up  closely 
does  harm. 

I^.     Ferri  et  quininae  citras,  12.0 

Elixir  simplex,  96.0 

S. — One  teaspoonful  three  times  daily. 

If  the  diarrhoea  is  severe,  give 

I^.     Bismutli  subgallate,  0.75 

F.  cliarta  No.  xii. 
S. —  One  powder  three  times  daily. 

Infectious  Hemorrhagic  Gastroenteritis. 

{Canine  Typhus,  Stuttyort  Day  Disease,  Dog  Plague.) 

This  disease  may  be  descril)ed  as  a  grave  infectious  disease,  having 
some  of  the  characters  of  distemper.     The  characteristic  lesion  being  an 


284  DISEASES  OF  TRUE  INFECTION 

acute  hemorrhagic  inflammation  of  the  intestinal  mucous  membrane 
and  frequently  accompanied  l)y  an  ulcerative  stomatitis.  This  disease 
attacks  animals  of  all  ages;  occasionally  a  milder  form  is  observed,  in- 
dicated by  severe  pharyngitis  and  gastric  catarrh  and  is  differentiated 
from  simple  gastric  catarrh  by  the  more  acute  symptoms  and  the  fact 
that  it  does  not  respond  to  the  ordinary  treatment  used  in  simple  catarrh. 

The  disease  was  described  by  Hoffer  in  1850  as  dog  typhus;  and  dur- 
ing the  latter  portion  of  the  nineteenth  century  it  spread  over  the  greater 
part  of  Europe  and  destroyed  numlicrs  of  animals.  Then  the  outbi'eak 
lessened  in  severity  and  only  sporadic  cases  were  observed,  but  recently 
it  appears  with  increased  severity. 

Etiology. — The  disease  attacks  animals  of  all  ages,  but  seems  to  pre- 
dominate in  older  animals.  Klett  made  a  record  of  100  cases  and  found 
five  cases  in  animals  under  one  year,  sixteen  in  second  year,  twenty-one  in 
third  year,  eleven  in  fourth  year,  nine  in  sixth  year,  seven  in  seventh 
year  and  eighth  year,  two  in  ninth,  six  in  tenth,  etc.  Sex,  constitution 
and  breed  do  not  seem  to  hinder  or  have  any  bearing  on  the  course  or 
severity  of  the  disease  although  Rabus  observed  the  delicate,  highly 
nervous  animals  that  are  very  carefully  housed  seem  to  be  more  suscepti- 
ble and  succumb  to  attacks  of  the  disease. 

The  actual  cause  of  the  disease  or  medium  of  infection  has  not  been 
definitely  described.  Some  oliservers  think  the  faeces  is  the  medium  of 
the  infection,  some  the  urine,  some  the  vomited  material,  others  the 
urine,  blood,  or  other  tissue  fluids,  but  the  majority  of  observers  agree 
that  the  disease  gains  entry  into  the  system  by  means  of  the  digestive 
tract.  It  is  not  definitely  known  if  it  is  directly  transmissible  to 
another  animal,  and  the  direct  inoculation  of  the  disease  is  only  accom- 
plished with  great  difficulty  and  after  repeated  experiments,  and  even 
then  it  is  governed  l)y  certain  favorable  circumstances.  Albrecht  injected 
a  healthy  dog  with  blood  taken  from  an  animal  affected  with  the  disease. 
Into  a  second  dog  he  injected  subcutaneously  a  certain  amount  of  bile 
from  the  gall-bladder  of  another  infected  animal.  Into  the  third  animal 
he  administered  a  quantity  of  the  contents  of  the  stomach  of  a  diseased 
animal.  The  animal  that  had  the  subcutaneous  injection  of  bile  developed 
a  severe  abscess  at  the  point  of  puncture  and  made  a  good  recovery. 
The  other  animals  were  not  afTected  at  all.  Scheibel  fed  finely  cut  up 
portions  of  the  stomach  and  intestines  of  affected  animals  without  any  ill 
affects,  but  when  he  had  given  an  animal  a  solution  of  bicarbonate  of  soda, 
rendering  the  mucous  mem]:)rane  of  the  stomach  alkaline,  the  animal 
developed  the  disease  two  days  later.  Scheibel  came  to  the  conculsion 
that  a  mixed  infection  of  the  coli-bacteria  and  micrococci  was  more  apt 
to  reproduce  the  disease.  Pirl  found  in  the  blood  taken  from  the  heart 
of  the  diseased  animal  an  oi'ganism  which  was  similar  to  the  bacterium 


INFECTIOUS  HEMORRHAGIC  GASTROENTERITIS  285 

hemorrhagiciim.  Zschokke  found  in  the  serum  of  the  kichieys  of  an 
animal  that  had  just  died  numerous  sk^nder  cocci-bacteria.  The  majority 
of  French  observers  beheve  that  the  disease  must  be  classed  under  the 
head  of  the  pasteurellas.  Bimis  and  Seris  contend  that  this  disease  is 
simply  a  very  malignant  form  of  distemper.  Hutyra  obtained  from  the 
mucous  glands  of  the  mucous  meml^rane  of  the  intestine  and  from  the  in- 
testinal contents  virulent  coli-liacilli.  The  intravenous  injection  of  an 
experimental  bouillon  culture  produced  fatal  hemorrhagic  gastro-enteritis, 
whereas,  if  the  stomach  was  previously  neutralized,  the  bouillon  could  be 
fed  to  the  animals  and  produce  no  effect  whatever. 

Pathological  Anatomy. — Severe  inflammatory  alterations  will  be 
found  along  the  digestive  apparatus.  The  stomach  is  found  to  be 
be  contracted  to  very  small  compass  and  rarely  contains  any  food  of  any 
kind.  The  mucous  membranes  are  swollen,  red  to  black-red,  containing 
more  or  less  hemorrhagic  spots  and  covered  with  a  foetid  brown  colored 
mucus  which  is  alkaline  in  reaction.  Similar  changes  but  not  so  severe 
are  found  in  the  duodenum.  The  rest  of  the  intestinal  tract  may  be 
affected  but  it  is  the  exception;  the  rectum,  however,  is  freciuently  in- 
flamed. The  peritoneum  is  injected,  the  liver  and  kidneys  are  more  or 
less  hyperoemic.  Zschokke  found  the  kidneys  presenting  all  the  symp- 
toms of  metastatic  suppurative  nephritis.  The  bladder  is  usually  dis- 
tended and  filled  with  urine,  the  mesenteric  glands  and  spleen  are  gener- 
ally slightly  enlarged.  The  cavity  of  the  mouth  is  ulcerated  with  necrotic 
processes  in  various  places,  particularly  about  the  gums,  and  there  are  more 
or  less  inflammatory  changes  of  the  mouth  and  swelling  of  the  tonsils. 

Clinical  Symptoms  and  Course. — The  first  symptom  is  a  want  of 
appetite,  which  is  soon  entirely  lost,  great  depression  and  want  of  anima- 
tion, frequent  vomiting  and  great  thirst.  The  vomited  matter  is  at  first 
streaked  with  bile  but  frequently  it  is  brownish-red  or  the  color  of  blood 
and  in  the  latter  stages  the  vomited  matter  is  very  foetid,  brownish  in 
color.  The  animal  defecates  with  difficulty,  and  if  the  temperature  is 
taken  the  thermometer  is  found  to  be  streaked  with  l^lood.  After  a  few 
days  the  animal  has  a  bloody  diarrhoea  with  an  intensely  offensive  odor. 
The  urine  is  decreased  in  quantity  and  frequently  the  urine  is  passed  with 
more  or  less  difficulty.  It  is  found  on  examination  to  contain  albumin 
and  bile  coloring  matter.  The  abdomen  is  drawn  and  tucked  up  and 
palpation  of  the  abdomen,  particularly  in  the  region  of  the  stomach,  is 
very  painful.  The  eyes  are  sunken  deep  in  their  sockets.  The  conjunc- 
tiva is  intensely  injected  and  in  severe  cases  the  congested  conjunctiva  is 
brownish-red  and  the  pupils  are  fixed  and  dilated.  There  is  more  or 
less  discharge  of  tenacious  yellow  mucus  from  the  nostrils,  the  pulse  is 
small  and  thready,  and  the  heart  has  a  full  throbbing  beat.  The  tem- 
perature is  not  particularly  high,  generally  about  40  degrees;  only  in 


286  DISEASES  OF  TRUE  INFECTION 

rare  instances  it  rises  above  that  and  in  cases  of  a  fatal  termination  it  is 
invariably  subnormal.  The  mouth  is  frequently  kept  tightly  shut  by 
the  animal  and  efforts  made  to  open  it  cause  the  animal  great  pain.  The 
mouth  and  breath  have  a  particularly  fcetid  odor,  particularly  when  the 
disease  is  well  developed,  and  we  find  the  gums  and  jaws  and  cheeks  covered 
with  deep  ulcerous  patches.  The  tongue  varies;  it  may  be  brownish- 
red,  bluish-gray,  or  extremely  pale  and  on  the  upper  surface  of  the  tongue 
it  is  coated  by  dirty  brownish-red  mucus.  Frequently  the  tongue  lies 
on  the  floor  of  the  mouth  apparently  paralyzed.  In  some  cases  the 
mouth,  throat,  and  mucous  membrane  of  the  tongue  are  covered  by  sticky 
moist,  purulent  mucus  and  occasionally  we  find  necrosis  of  the  tip  of  the 
tongue.  In  some  fatal  cases  we  find  little  change  in  the  mouth  and 
pharynx  other  than  deep  redness  of  the  mucous  membranes. 

When  the  disease  goes  on  rapidly  to  a  fatal  termination,  the  animal 
becomes  emaciated  very  rapidly,  lies  motionless  in  one  position  and  dies 
within  a  week.  In  rare  instances  the  animal  may  have  convulsions  before 
death.  Mettel  found  pneumonia  and  haematuria  and  Richta  found  hem- 
orrhage in  the  anterior  chamber  of  the  eye.  If  the  disease  lasts  over  ten 
days  without  fatal  results,  the  mouth  commences  to  clear  up,  the  ulcers 
become  covered  with  a  brownish  scab,  the  vomiting  ceases,  the  appetite 
returns,  and  in  two  or  three  weeks  the  animal  has  fully  recovered.  Par- 
alysis of  the  body  and  extremities  may  result,  and  deafness  may  occui-  as 
an  after-result  of  this  disease.  In  milder  cases  there  are  generally  all  the 
symptoms  of  acute  gastric  catarrh  with  pharyngitis.  It  is  rather  difficult 
in  sporadic  cases  to  diagnose  between  this  disease  and  simple  attacks  of 
gastric  catarrh  and  pharyngitis,  but  when  we  find  a  number  of  cases  and 
where  the  odor  from  the  mouth  is  particularly  offensive  and  also  the  faeces, 
the  chances  are  it  is  hemorrhagic  gastro-enteritis. 

The  prognosis  is  very  unfavorable.  The  mortality  is  from  50  to  70 
per  cent.,  and  even  the  milder  forms  of  the  disease  seem  extremely 
hard  to  treat  and  frequently  terminate  fatally;  young  animals  seem  to  be 
able  to  throw  off  the  disease  better  than  older  animals,  and  young  animals 
are  much  more  apt  to  have  a  milder  attack. 

Therapeutics. — Treatment  in  well-developed  cases  is  generally  hope- 
less. As  a  rule  it  is  well  to  give  the  animals  easily  digested  food,  keep 
the  animal  in  a  warm  place  free  from  draughts,  and  if  there  is  abdominal 
pain  apply  the  Priessnitz  compress.  In  case  of  persistent  vomiting,  use 
hot  applications  to  the  region  of  the  stomach,  or  wash  out  the  stomach 
with  weak  solution  of  creolin,  alum,  borated  water  or  .8  per  cent,  sodium 
chloride.  Small  quantities  of  broken  up  ice  frequently  administered  may 
check  the  vomiting,  also  morphia  (-Klett),  tincture  of  iodine  and  chloform, 
aa5.0  in  3  to  10  drop  doses  in  water  or  milk  (Cadiot).  Creasote  solution, 
(one  drop  in  ess.  of  pepsin).     For  stomach  and  intestinal  irritation,  salicylic 


SEPTICOPY.EMIA  287 

acid,  salol,  tincture  of  rhul-);!!'!),  iclitargan,  calomel  and  opium,  bismuth  sub- 
nitrate,  adrenaline  solution,  all  have  been  recommended  for  this  condition. 
For  lessening  the  fever,  phenacetin  and  quinine  have  been  recommended. 

For  the  local  treatment  of  the  ulcerated  mucous  meml^rane,  washes 
of  permanganate  of  potash,  1  to  200,  creolin  1  to  100,  peroxide  of  hydrogen 
solution. 

To  combat  extreme  weakness  give  camphor,  caffeine,  atropia.  Klett 
used  a  subcutaneous  injection  of  physiological  salt  solution.  Alcohol, 
pure  or  in  spirits,  is  not  recommended.  For  violent  foetid  diarrho'a  give 
pinch  of  tannoform,  tannothymol  or  xeroform.  For  intestinal  cramps  or 
colic  give  salts  of  bromine,  morphia  or  sulphonal. 

The  treatment  of  the  paralysis  that  may  follow  as  a  sequel  is  taken 
up  under  Diseases  of  the  Spine  and  its  Coverings. 

SEPTIC  AND  PYEMIC  DISEASES. 

Septicopyaemia. 

Etiology. — This  disease  is  caused  by  staphylococci  or  streptococci, 
frequently  by  the  bacterium  coli,  and  occasionally  by  proteus  or  micro- 
organisms related  to  them.  The  microbes  may  collect  in  a  wound  or  they 
may  accumulate  in  some  centre  in  the  body,  later  find  their  way  into  the 
blood  and  give  rise  to  the  characteristic  symptoms  of  the  disease,  that  is, 
high  fever  and  great  depression  and  these  pus-forming  organisms  settle  in 
the  capillaries  and  form  metastatic  abscesses  which  appear  in  different 
organs  of  the  body,  and  pyiemia  when  accompanied  by  the  formation  of 
abscesses  and  suppuration.  It  is  termed  septicaemia  when  there  is  high 
fever  and  general  depression.  It  is  extremely  hard,  however,  to  make  a 
sharp  distinction  between  the  two,  for  undoubtedly  the  nature  and  in- 
tensity of  the  disease  depends  not  only  on  the  nature  of  the  bacteria,  but 
also  on  the  toxic  effects  of  the  same  and  the  individual  resistance  of  the 
animal  affected. 

This  condition  can  originate  from  purulent,  ichorous,  or  gangrenous 
wounds,  ulcers,  circumscribed  or  diffuse  phlegmons,  complicated  frac- 
tures, decubitus,  puerperal  diseases,  putrid  abscesses  of  the  stomach 
and  intestines,  acute  inflammation  and  sloughing  of  the  buccal  cavity  and 
pharynx,  abscess  of  the  prostate.  In  many  cases  the  original  cause  can- 
not be  discovered. 

Clinical  Symptoms. — Fever,  ushered  in  by  chills,  high  temperature — 
this  may  fluctuate  and  towards  the  end  it  may  be  subnormal — small  ac- 
celerated pulse,  great  weakness  of  heart,  livid  red  mucous  membranes;  in 
rare  instances  the  mucous  membranes  are  yellowish  (icteric) ;  sometimes 
hemorrhages  of  the  mucous  membrane  and  skin,  great  dulness  and  then 


288  DISEASES  OF  TRUE  INFECTION 

complete  prostration,  no  appetite,  skin  cold  and  inelastic.  When  the 
skin  is  drawn  from  the  body  it  remains  in  position  instead  of  flying  back 
as  healthy  elastic  skin  will  do;  foetid  stools,  albuminuria.  As  a  rule  death 
comes  quickly.  In  less  acute  cases  we  find  symptoms  of  nephritis, 
hepatitis,  endocarditis,  or  evidences  of  localization  of  the  condition  in 
the  formation  of  abscesses  of  the  lungs,  liver,  or  in  the  articulations. 

Therapeutics. — There  has  been  no  specific  serum  that  seems  to  have 
any  effect  on  the  disease,  so  the  symptoms  must  be  treated  as  they  appear. 
Try  to  keep  up  the  strength  of  the  patient,  administer  alcohol  in  the  form 
of  wine,  whiskey,  or  brandy  frequently,  and  strong  liquid  foods.  Digi- 
talis and  strophanthus  have  not  given  good  results  in  keeping  up  the  heart's 
action  in  septic  diseases;  to  cut  down  the  fever  use  antipyrin,  antifebrin  or 
Cj[uinine;  the  latter  should  not  be  given  if  the  heart  is  particularly  weak. 
To  assist  in  eliminating  the  microbes,  administer  a  hypodermic  injection 
of  from  30  to  300.0  c.c.  of  an  8  per  cent,  solution  of  chloride  of  sodium. 
It  is  well  to  keep  in  mind  the  importance  of  antiseptics  in  all  wounds  and 
operations,  and  any  ^^I'ocess  of  disease  that  will  tend  to  produce 
septicopysemia. 


Malignant  CEdema. 

{CEdemu  Maligna.) 

This  disease  is  extremely  rare  in  the  dog.  It  is  an  acute  infectious 
disease  caused  by  a  specific  bacterium  (bacillus  oedematis  malignae).  It 
begins  at  a  certain  infected  point  in  the  form  of  a  hot,  painful  oedematous, 
pitty  swelling  which  afterwards  becomes  an  emphysematous  (crepitating) 
swelling  which  extends  very  rapidly  into  the  surrounding  tissues.  This 
crepitation  is  peculiar  to  the  disease,  and  can  be  separated  from  simple 
emphysema  by  the  fact  that  in  simple  emphysema  there  is  no  fever  pres- 
ent. Immediately  after  death  the  bacilli  are  found  in  the  serum  of  the 
oedematous  swellings  and  in  the  blood. 

This  Bacillus  oedematis  malignse  is  not  only  found  in  animals  but  also 
in  garden  soil,  dust,  putrid  organic  materials,  excrement  of  herbaceous 
animals,  etc.  It  has  been  demonstrated  recently  that  the  oedema  bacillus 
only  develops  when  in  combination  with  other  bacilli  such  as  the  staphylo- 
cocci, diplococci,  etc. 

The  treatment  of  malignant  oedema  must  be  very  energetic,  as  the 
disease  causes  death  in  a  very  short  time.  It  consists  in  opening  and 
breaking  down  the  infected  connecting  tissues  and  thoroughly  disinfecting 
them,  first  cleaning  them  out  with  peroxide  of  hydrogen,  and  then 
washing  with  a  1  to  3000  solution  of  corrosive  sublimate. 


ANTHRAX  289 

Anthrax. 

{Charhon.     Malignant  Pustule.     Splenic  Fever.) 

Anthrax  is  rare  in  the  dog,  and  when  it  occurs  it  is  generally  caused 
by  the  animal  eating  portions  of  cadavers  of  animals  that  have  had  this 
affection.  This  is  an  acute  infectious  disease  which  is  caused  by  the 
Bacillus  anthracis,  and  is  accompanied  by  high  fever  and  local  mani- 
festations in  the  skin  and  mucous  membranes.  All  forms  of  anthrax 
have  been  observed  in  the  dog,  but  generally  the  seat  of  the  disease  is  in 
the  mouth,  throat  and  in  the  intestines,  and  generally  there  is  more  or 
less  tumefaction  of  the  head.  One  observer  saw  a  typical  case  of  anthrax 
of  the  tongue  and  lips  caused  by  an  animal  licking  the  l^lood  of  an  animal 
that  had  that  disease.  Another  case  observed  was  where  a  terrier  had 
eaten  a  bone  of  an  animal  affected  with  anthrax.  Lupke  found  on  the 
inferior  wall  of  the  throat  a  carbuncle,  which  was  probably  caused  by  an 
erosion  of  the  epithelium,  in  which  there  was  great  inflammatory  oedema 
of  the  adjacent  regions.  In  regard  to  the  susceptibility  of  the  dog  to  an- 
thrax, one  case  is  cited  where  150  dogs  ate  the  flesh  of  a  horse  that  had 
died  of  anthrax;  100  had  swelling  of  the  lips,  throat,  forehead  and  head, 
and  sixty  of  them  died.  Young  dogs  seem  much  more  susceptible  than 
older  animals.  Different  breeds  of  dogs  are  said  to  be  less  susceptible 
to  anthrax  than  others;  this,  however,  is  a  question.  When  a  number  of 
animals  are  affected  wdth  symptoms  of  anthrax,  particularly  packs  of 
hounds,  when  the  dead  cadaver  is  fed  to  the  hounds,  the  proper  method 
of  diagnosis  would  be  to  examine  the  blood  microscopically  and  make 
a  trial  inoculation  of  an  animal  that  had  not  been  near  the  infected 
animals. 

Therapeutic  treatment  is  generally  useless  on  account  of  the  rapid  pro- 
gress of  the  disease.  If  any  treatment  is  attempted  it  may  be  in  the  line 
of  the  internal  administration  of  antiseptics,  creolin,  carbolic  acid,  salicylic 
acid,  and  preparations  of  iodine  particularly  Donovan's  solution.  AVhere 
the  carbuncle  is  formed  then  local  incisions  and  the  injection  of  corrosive 
sublimate  solution,  1  to  1000,  and  tincture  of  iodine.  The  actual  cautery 
has  been  recommended  to  destroy  the  tissue  of  the  carbuncle.  Concern- 
ing sanitary  laws,  the  following  apply  to  this  disease: 

Animals  which  suffer  from  or  are  suspected  of  anthrax  cannot  be 
slaughtered  for  consumption. 

Any  operation  that  will  cause  bleeding  of  the  animal  suspected  of 
anthrax  can  only  be  performed  under  the  supervision  of  the  official 
veterinarian. 

All  cadavers  of  animals  which  are  affected  or  suspected  of  having 
19 


290  DISEASES  OF  TRUE  INFECTION 

anthrax  must  be  rcnderetl  harmless  by  burning  the  cadavers.     Skinning 
the  animal  is  strictly  forbidden. 

Rabies. 

{Hijdrophobia.) 

This  is  an  acute  disease  of  the  entire  nervous  system  caused  by  a 
specific  poison,  and  distinguished  by  a  variable  period  of  incubation,  as 
well  as  by  an  absence  of  any  marked  anatomical  alteration. 

Etiology. — Rabies  is  a  true  infectious  disease,  and  never  occurs 
spontaneously,  but  is  only  transmitted  by  direct  infection  through  the 
bite  of  affected  animals.  This  disease,  as  a  rule,  is  confined  to  the  canine 
race  (dog,  wolf,  fox,  hyena,  and  jackal).  It  is  seen  in  rare  instances  in 
the  cat,  horse,  cattle,  sheep,  goat,  deer,  guinea-pig,  rabbit,  rat,  mouse, 
chicken,  pigeon,  and  in  man.  The  dog  is  the  animal  that  contracts  the 
disease  quicker  than  any  other.  Country,  climate,  care,  nursing,  age, 
and  sex  do  not  seem  to  have  any  influence  upon  it.  The  disease  is  more 
frequently  seen  in  central  Europe  and  in  New  England  and  Middle  States 
than  anywhere  else.  This  may  be  accounted  for  by  the  fact  that  dogs  in 
large  numbers  run  at  large,  and  also  to  the  fact  that  the  owners  do  not 
conform  to  the  rules  of  sanitary  police.  Rabies  does  not  seem  to  be  in- 
fluenced to  any  great  extent,  by  the  seasons  of  the  year,  but  cases  are  more 
frequently  seen  in  the  spring  and  summer  than  in  the  autumn  and  winter. 
The  poison  of  rabies  is  as  yet  unknown,  or  at  least  it  has  not  been  definitely 
described.  It  is  reproduced  in  the  body  of  the  animal  only;  never  outside 
of  it.  It  is  mixed  with  blood,  saliva  in  the  salivary  glands,  and  in  the 
secretions  of  the  lachrymal  glands.  It  is  also  said  to  occur  in  the  mam- 
mary glands.  From  direct  inoculations,  this  disease  appears  in  its  most 
concentrated  form  in  the  brain,  spine,  and  in  the  ganglionic  nerves. 

This  poison  is  virulent  in  the  spine  and  brain,  during  the  incubative 
period,  and  retains  its  full  strength  for  several  days  after  the  death  of  the 
affected  animal.  Roux  and  Nocard  have  found  that  the  saliva  is  infectious 
two  or  three  days  before  any  symptoms  of  the  disease  appear,  and  one 
case  recorded  by  Pampouki,  in  which  a  woman  was  infected  by  a  dog 
eight  days  before  the  actual  symptoms  appeared  in  the  dog.  The  actual 
excitant  of  the  disease  does  not  appear  to  be  present  in  the  muscles,  the 
lymphatic  glands,  liver  or  spleen,  and  the  urine  or  spermatic  fluid  has  not 
been  found  virulent  and  the  rabic  poison  has  been  found  in  very  rare 
instances  in  the  aqvicous  humor.  The  true  cause  of  rabies  has  not  as  yet 
been  isolated  and  described,  probably  it  is  an  ultra-microscopical  organism, 
at  least  it  seems  so  to  a  large  number  of  observers  (Rimlinger,  Riffet, 
Rey,  Schander,  C'clli,  Blase,  etc.) ,  who  have  passed  a  brain  emulsion  through 


RABIES  291 

specially  fine  filters,  and  an  inoculation  with  the  filtrate  has  successfully 
reproduced  the  disease. 

In  1903  Negri  found  both  in  inoculated  and  rabid  street  dogs,  in  certain 
parts  of  the  cerebral  nervous  system,  particularly  in  the  horns  of  the  amnion, 
in  the  Pur  kin  je  cells  of  the  cerebellum,  in  the  nerve  cells  of  the  pons,  in  the 
cord  and  the  central  cortex,  when  sections  of  these  parts  were  stained  by 
Mann's  method,  (methyl  blue-eosin),  certain  bodies  which  took  up  the 
stain,  and  appeared  a  brick  red,  these  bodies  being  round  or  slightly 
oval,  periform,  or  even  irregular  triangles,  and  varying  greatly  in  size, 
from  1  to  27 tx;  either  isolated  or  grouped  in  the  cells.  These  were  found 
in  dogs  affected  with  rabies,  as  well  as  other  rabid  animals  and  man. 
They  retain  their  characteristics  even  when  the  cadaver  was  in  a 
state  of  advanced  putrefaction  and  remain  perfect  in  glycerine.  Negri 
regards  these  as  the  various  stages  of  evolution  of  a  parasite  which 
should  be  classed  with  the  "protozoa"  and  claims  these  as  the  true 
excitors  of  rabies.  It  is  true  that  for  some  time  before  Negri  had  an- 
nounced his  theory,  a  number  of  observers  thought  that  the  origin  of  rabies 
must  be  due  to  the  protozoa,  particularly  Dijestal,  who  had  described 
having  seen  in  the  spine  and  ganglionic  nerves,  small  bodies  like 
protozoa. 

These  bodies  are  to-day  generally  known  as  Negri's  corpuscles  or 
bodies,  (see  plate) ,  and  have  since  been  observed  and  described  by  a  num- 
ber of  other  observers,  and  studied  particularly  with  regard  to  their 
minute  structure  ( Volpino,  Williams,  Bohn) ,  and  it  must  be  admitted  that 
they  are  found  with  great  regularity  in  rabid  dogs  and  their  presence  is 
regarded  as  diagnostic. 

In  1903  to  1905,  457  dogs  suspected  of  rabies  were  examined 
by  Italian  scientists;  297  were  proved  by  inoculation  to  be  rabid  and  in  all 
but  nine  the  corpuscles  of  Negri  were  found. 

The  claim  of  Negri  that  this  specific  parasite  (protozoon)  is  the  true 
and  only  cause  of  rabies  is  a  question  that  is  opposed  by  those  observers 
who  have  filtered  the  emulsified  brain  substance  of  an  affected  animal 
and  the  filtrate  reproduced  the  disease  by  inoculation;  there  is  a  possibility, 
however,  that  certain  of  these  corpuscles  may  be  so  infinitesimal  as  to 
pass  through  the  filter  and  so  small  as  to  be  beyond  the  power  of  the 
microscope  to  render  them  visible. 

Pasteur  has  demonstrated  that  a  rabid  brain  loses  its  infectious 
virulence  only  when  that  part  has  become  partially  decomposed,  that  is 
to  say,  after  four  or  five  days;  while  it  remains  virulent  in  air-tight  tubes 
or  in  moistened  carbolic  gauze.  Neustube  found  that  the  brain  of  a 
rabid  dog  retained  its  virulent  properties  when  kept  under  a  slightly 
elevated  temperature  for  ten  or  twelve  days.  Mergel  found  the  virulence 
as  strong  as  ever  in  the  putrid  brain  of  a  rabid  wolf  fourteen  days  after 


292  DISEASES  OF  TRUE  INFECTION 

the  animal  had  ])een  killod.  Galticr  noticed  the  same  conditions  in  the 
decayed  brain  substance  of  a  rabid  dog,  when  kept  under  a  low  tempera- 
ture (12°  Celsius).  An  affected  brain  was  not  rendered  harmless  even 
when  exposed  for  three  weeks  at  a  time,  but  its  virulence  was  attenuated 
wdien  kept  some  time  at  a  temperature  of  61°  Celsius.  Bluml)erg  found 
that  an  affected  brain  is  rendered  harmless  when  it  has  undergone  a  freez- 
ing process  at  20°  or  30°.  Galtier  was  able  to  destroy  the  virulence  of  af- 
fected cerebral  matter  in  four  to  twenty  days  by  placing  it  upon  plates  and 
allowing  it  to  become  dry.  Saliva  and  blood  are  much  less  resistant  than 
brain  matter.  Both  su])stances  as  a  rule,  lose  their  harmful  properties 
twenty-four  hours  after  leaving  the  animal.  Dried  saliva  is  inactive 
fourteen  hours  after  it  comes  from  the  mouth  of  the  animal,  the  gastric 
juice  destroys  it  in  five  hours;  bile  kills  it  in  a  few  minutes,  and  it  is  de- 
stroyed quickly  by  corrosive  sublimate,  chlorine  water,  permangate  of 
potash,  sulphuric  acid,  creolin,  etc.  The  X-rays  seem  to  retard  the 
development  of  the  virus. 

As  a  rule,  it  is  necessary  to  make  a  natural  or  artificial  inoculation  in 
order  to  obtain  any  successful  transmission  of  the  rabid  poison,  as  no  in- 
fection will  take  place  if  an  animal  is  given  the  saliva,  flesh,  brain  or  spinal 
cord  of  an  affected  animal,  or  if  the  inoculation  is  simply  rubbed  on  the 
cutaneous  or  mucous  membranes;  but  if  the  mucous  membrane  is  scarified 
first  it  can  be  reproduced.  The  most  certain  method  to  reproduce  the 
disease  is  to  introduce  the  virus  directly  on  the  dura  mater  of  the  brain 
or  spinal  cord,  or  in  the  anterior  chamber  of  the  eye.  Heredity — that  is, 
transmission  of  rabies  by  the  mother  to  puppies  or  the  production  of  the 
disease  by  infected  saliva  being  in  food — is  very  questionable.  The  most 
common  method,  of  course,  is  the  bite  of  the  rabid  animals;  more  rarely 
licking  of  a  wound.  In  many  cases  the  bite  may  not  be  severe  enough  to 
cause  its  development  in  dogs  or  in  man.  Deep  bites,  however,  are 
certainly  the  most  dangerous,  especially  when  made  on  the  unprotected 
parts  of  the  body  (hands  and  face  in  man).  Wounds  which  bleed  much 
are  less  dangerous,  as  the  poison  may  be  washed  out  of  the  wound  by  the 
flowing  blood.  Bites  of  dogs  which  have  bitten  numerous  others  are 
less   dangerous  than  the  first  or  second  bite  made  by  a  rabid   animal. 

Infectious  wounds  which  were  made  by  biting  or  inoculation,  accord- 
ing to  Hertwig's  observations,  showed  only  37  per  cent,  of  positive  results, 
and  Renault's  67  per  cent.  Of  137  animals  which  were  bitten  by  rabid 
dogs  under  observations  for  the  last  five  years  at  the  Veterinary  College  of 
Berlin,  six  only  ultimately  developed  the  disease.  Zundel  finds  that 
about  25  per  cent,  of  inoculated  animals  become  affected,  while  Haubner 
found  40  per  cent.  At  Alfort  they  have  found  the  proportion  to  be  about 
33  per  cent.,  and  at  Lyons,  26  per  cent.  In  man  50  per  cent,  of  the 
bitten  subjects  develop  the  disease,  but  if  we  sum  together  the  cases  of 


RABIES  293 

true  rabid  and  ''suspected"  dogs,  the  proportion  is  reduced  to  about  8 
per  cent. 

The  most  dangerous  bites  seem  to  be  those  directly  into  a  nerve  or  upon 
nerve  tissue,  even  if  it  is  on  the  smaller  branches  of  nerves,  whereas  a  bite 
on  blood  vessels  or  the  lymphatic  system  is  less  so,  and  artificial  inoculation 
proves  that  if  it  is  made  as  near  to  the  central  nervous  system  as  possible 
the  disease  makes  its  appearance  more  quickly,  and  the  injection  directly 
on  the  dura  mater  produces  the  disease  in  shorter  time  and  more  certainly 
than  any  other  part  of  the  bod}-.  Pasteur  claimed  that  if  there  is  the 
largest  proportion  of  virus  in  the  brain,  it  produces  furious  rabies,  and  if 
the  virus  predominates  in  the  spine  it  causes  dumb  rabies.  It  is  possible 
that  the  results  of  the  material  changes  on  the  animal  economy  produced 
by  the  disease  ''toxines"  may  have  some  effect  on  the  character  and 
severity  of  the  disease,  the  nature  of  which  is  at  present  really  not 
known.  Anrep  prepared  a  serum  from  the  brain  of  guinea-pigs  affected 
with  furious  rabies;  this  serum  injected  into  animals  produced  lowering  of 
temperature,  paralysis  of  the  extremities,  salivation,  and  death  by  para- 
lysis of  the  respiratory  centres. 

Pathological  Anatomy. — The  post-mortem  results  are  generally  nega- 
tive and  vary  in  different  animals,  but,  as  a  rule,  specific  alterations  are 
noticed.     These  are  as  follows: 

Great  emaciation  with  very  distinct  muscular  rigidity  and  a  rapid 
tendency  to  decay;  collections  of  mucus  upon  all  the  natural  orifices, 
such  as  the  mouth,  nose,  and  the  prepuce;  prominence  of  the  cutaneous 
veins,  which  are  found  to  be  filled  with  thick,  imperfectly  clotted  blood; 
redness  and  swelling  of  the  mouth  and  mucous  membranes.  The  throat 
is  covered  with  a  whitish-gray  mucous  exudation;  intense  inflammation  of 
the  glands  of  the  pharynx;  in  some  cases  slight  swelling  and  hyperaemia  of 
the  salivary  glands.  In  the  cavity  of  the  throat  and  mouth  we  find  for- 
eign bodies,  such  as  hair,  straw,  coal,  wood,  etc.;  they  may  also  be  found 
in  the  oesophagus,  which  is  frequently  very  red  and  covered  with  clammy, 
gray  mucus.  This  condition  is  seen  in  the  stomach  which  contains  little 
or  no  food  but,  as  a  rule,  numerous  indigestible  objects  of  various  kinds 
and  sizes — straw,  hair,  wood,  stones  or  pieces  of  leather  or  rags.  The 
mucous  membrane  is  reddened  and  swollen,  especiall}'  on  the  surface  of  its 
folds,  and  marked  with  hemorrhagic  erosions,  which  Johne  describes  as 
sepia-colored.  The  intestine  may  be  empty  or  it  may  contain  some  of  the 
foreign  bodies.  The  mucous  membrane  of  the  pharynx  is  always  very 
red,  swollen,  and  covered  with  mucus  in  its  anterior  portions.  These  alter- 
ations are  also  seen  in  the  trachea  and  the  large  bronchia.  The  lungs  are, 
as  a  rule,  filled  with  blood,  but  otherwise  normal.  In  rare  instances  we 
find  circumscribed  centres  of  irritation  due  to  foreign  bodies  being  inhaled 
through  the  bronchial  tubes.     The  heart  and  its  envelope  are  generally 


294  DISEASES  OF  TRUE  INFECTION 

normal.  The  inner  surface  of  the  pericardium  may  show  hemorrhagic 
spots.  The  chambers  of  the  heart,  as  well  as  the  large  blood  vessels,  are 
filled  with  dark,  imperfecth^  clotted  l^lood.  The  liver  and  kidneys  are 
hypersemic.  The  spleen  is  always  filled  with  blood,  enlarged,  and  oc- 
casionally streaked  with  hemorrhagic  spots;  the  bladder  is  found  to  contain 
little  urine,  and  this  on  test  is  found  to  contain  svigar.  Cadiot  was  inclined 
to  consider  glycosuria  as  a  regular  symptom  of  rabies  and  of  patholog- 
ical importance,  but  Rabreaux  and  Nicholas  took  the  ground  that  while 
sugar  is  apt  to  be  in  the  virine  of  rabid  animals,  still  its  absence  did  not 
mean  the  animal  did  not  have  rabies. 

The  condition  of  the  brain  and  spine  was  formerly  supposed  to  pre- 
sent some  reliable  indications  of  the  disease,  but  according  to  the  investi- 
gations of  the  last  few  years  it  cannot  be  said  that  they  present  any  constant 
pathological  alterations.  They  vary  greatly  and  in  some  cases  may  pre- 
sent no  noticeable  change  at  all.  We  frequently  find  hypersemia  of  the 
covering  of  the  brain  and  spinal  cord,  accompanied  by  slight  hemorrhages, 
and  the  brain  and  spinal  matter  itself  contains  more  blood  than  usual  and 
is  in  a  more  or  less  oedematous  condition. 

Kolesnikoff  found  on  microscopic  examination  of  the  walls  and  neigh- 
boring vessels  of  the  brain  (of  dogs  which  have  died  with  rabies)  an  accu- 
mulation of  lymphoid  cells  and  extravasated  red  blood  corpuscles.  The 
accumulation  of  discolored  cells  and  red  corpuscles  in  the  small  blood  ves- 
sels of  the  walls  and  perivascular  chambers  indicates  to  a  certain  extent  a 
condition  which  in  rabies  is  of  pathological  importance.  They  are  un- 
doubtedly symptoms  of  inflammation.  These  changes  vary  in  different 
cases.  According  to  Czoker,  it  was  noticed  to  a  very  slight  degree  in  dogs 
affected  with  the  furious  form  of  rabies,  but  it  was  noticed  to  a  marked 
degree  as  soon  as  the  disease  developed  the  dumb  form  (the  perivascular 
spaces  and  their  neighliorhood  were  filled  with  leukocytes). 

Babes  found  nodulated  infiltration  in  the  spinal  cord  of  dogs  that  he 
called  nodules  rabirjues  (rabid  nodules).  Other  observers  have,  however, 
found  them  in  distemper,  ^'an  Gehuchten  and  Xelis  found  in  the  cerel^ro- 
spinal  and  sympathetic  ganglion  of  a  street  dog  that  died  of  rabies  defi- 
nite lesions,  such  as  infiltration,  tumefaction  and  ecchymosis,  and  great 
proliferation  of  the  endothelial  cells  of  the  capsule  that  covers  the  gang- 
lionary  cells,  and  emigration  of  the  mononuclear  cells  and  a  destruction 
of  the  ganglionary  cells  (ncurophagy).  The  plexus  nodus  vagi  is  fre- 
quently attacked.  These  alterations  in  the  nerve  tissues  are  not  always 
present  in  the  disease  and  cannot  be  used  as  positive  evidence  of  the  dis- 
ease. Valleea  and  Manonelian  found  similar  infiltrations  of  the  ganglia 
in  very  old  dogs,  and  other  observers  found  these  modifications  in  less 
degree  in  other  diseases,  i^imilar  alterations  have  been  noticed  in  other 
diseased  conditions,  such  as  chorea,  tetanus,  distemper  and  meningitis. 


RABIES  295 

Clinical  Symptoms  and  Course. — The  period  of  incubation  lasts  in 
the  majority  of  cases  from  three  to  six  weeks.  In  very  rare  instances  the 
disease  maj^  appear  in  one  week.  According  to  Haubner's  observations 
upon  nearly  200  dogs,  in  83  per  cent,  of  the  cases  the  disease  developed  in 
two  months;  in  16  per  cent,  of  the  cases  within  three  months;  and  in  1 
per  cent,  four  months,  or  even  later.  Zundel  has  calculated  that  in  264 
dogs  1  per  cent,  became  affected  within  twenty-four  hours  after  being 
bitten;  11  per  cent,  between  the  second  and  third  day;  33  per  cent,  be- 
tween the  fifteenth  and  thirtieth  clay;  19  per  cent,  between  the  thirtieth 
and  forty-fifth  day;  10  per  cent,  between  the  forty-fifth  and  sixtieth  day; 
16  per  cent,  between  the  sixtieth  and  ninetieth  day,  and  10  per  cent, 
after  three  months.  The  longest  period  of  incubation  was  observed  by 
Leblanc;  this  case  developed  in  364  days.  The  period  of  incubation  is 
shorter  in  young  than  in  older  dogs.  In  the  human  race  it  is  generally 
admitted  that  the  average  period  of  incubation  is  seventy-two  days 
(this  average  covers  over  510  cases). 

There  are  two  forms  of  rabies — a  furious  and  mute  (or  dumb)  form. 
The  first  is  more  frequent,  but  there  are  numerous  transitions  between 
the  two  forms;  dogs  that  are  at  liberty  or  vagrant  dogs  are  more  apt  to 
have  the  violent  or  furious  form,  while  dogs  kept  as  house  pets  or  who 
are  restrained  are  more  frequently  affected  with  the  mute  or  dumb 
form,  and  in  dogs  that  are  well  trained  and  under  control  and  have  lived 
in  close  contact  with  man,  the  tendency  to  bite  is  only  present  when  they 
have  reached  the  point  of  true  delirium  and  mental  control  is  gone. 
Pasteur  found  that  intracranial  injection  produced  furious  rabies,  while 
subcutaneous  injection  almost  invariably  resulted  in  the  dumb  form. 

Furious  Rabies. — This  comprises  three  distinct  stages,  between  which 
there  is  a  very  distinct  line  of  demarcation — namely,  the  prodrome  or 
melancholic,  the  stage  of  irritation,  and  the  paralytic  stage. 

In  the  melancholic  stage  the  dogs  seem  to  change  in  their  disposition. 
They  are  capricious,  and  at  other  times  irritable  or  depressed.  They  show 
symptoms  of  anger,  are  easily  excited,  fretful,  change  from  one  place  to 
another,  are  easily  frightened  on  the  slighest  cause  or  may  become  very 
affectionate.  They  soon  show  a  tendency  to  gnaw  or  swallow  indigestible 
substances.  They  refuse  their  usual  food,  or  they  may  take  such  food  as 
they  have  a  special  taste  for,  holding  it  in  their  mouth  for  a  few  moments 
and  then  let  it  drop  out  of  the  mouth  again.  They  will  lick  and  gnaw,  in  a 
greedy  manner,  various  objects,  such  as  wood,  coal,  furniture,  and  eat  sti'aw, 
earth,  stones-,  wood,  blankets,  and  even  their  own  fieces.  In  one  case 
observed  by  Govard,  the  animal  would  howl  loudly,  have  an  evacuation 
of  faeces  and  immediately  eat  it.  There  is  commencing  evidence  of 
paralysis  in  difficulty  in  deglutition,  cough,  and  labored  respiration. 
The  sexual  desire  is  very  much  increased,  and  we  see  in  the  first  stage  an 


29G  DISEASES  OF  TRUE  INFECTION 

uncertainty  in  the  gait  and  a  weakness  in  the  hind-quarters.  Constipation 
is  invariably  present.  After  a  short  space  of  time,  generally  from  one  to 
three  days,  the  second  stage  appears.  This  is  the  irritable  or  maniacal 
stage.  This  is  characterized:  1.  By  a  tendency  to  escape  and  run  away; 
2.  by  a  great  irritation  and  an  inclination  to  bite  animals,  objects,  or 
man;  3.  by  a  strange  alteration  in  the  voice,  or  bark. 

The  inclination  to  run  off  is  very  marked.  They  will  eat  through 
wooden  boxes  or  floors,  tear  chains  apart,  or  dig  great  distances  through 
earth.  As  soon  as  they  get  their  liberty  they  will  run  about  aimlessly, 
covering  very  much  ground  in  a  short  space  of  time,  and  return  in  one  or 
two  days,  showing  every  indication  of  great  excitement  or  of  having 
travelled  long  distances.  When  they  return  they  are  covered  with  dirt 
and  utterly  exhausted,  and  may  be  very  quiet  and  well  behaved  for  a 
short  time.  During  this  condition  they  bite  any  object  that  comes 
in  their  way.  Soon  the  delirium  increases  and  they  run  around  in  an 
insane  way,  attacking  and  biting  anything  that  is  within  their  reach, 
snarling  or  biting  all  the  time,  and  if  they  are  confined  they  bite  at  the 
bars  and  frequently  break  their  teeth,  and  if  a  stick  is  held  toward  them 
they  attack  it  furiously.  As  a  rule  these  cases  do  not  tear  or  mutilate 
their  own  bodies,  and,  if  they  do,  they  generally  bite  the  region  of  the 
wound  where  they  were  formerly  bitten  or  the  toes  of  the  posterior  ex- 
tremites.  In  the  first  stage  of  the  disease  we  have  often  noticed  that  they 
will  lick  and  bite  places  where  they  have  had  wounds  before.  The 
patients  snap  frequently,  as  if  they  were  catching  flies,  and,  as  a  rule,  will 
bite  any  animal  that  will  come  within  their  reach. 

The  biting  and  delirium  are  not  constant,  but  appear  after  alternate 
periods  of  rest,  followed  by  uncontrollable  delirious  attacks,  especially 
if  another  dog  should  come  near.  These  attacks  may  occur  at  intervals 
varying  from  one  to  four  hours.  The  peculiar  change  in  the  voice  is  due 
to  a  paralysis  of  the  vocal  cords,  and  the  sound  of  the  bark  is  prolonged 
into  a  higher  vocal  sound,  so  that  it  makes  a  combination  between  a  howl 
and  a  bark,  which  has  been  described  by  different  authors  as  a  "howling" 
bark.  This  is  harsh  and  shrill.  Repugnance  to  water  does  not  exist 
in  the  dog  as  in  man,  but  toward  the  end  of  the  second  stage,  from 
paralysis  of  the  muscles  of  deglutition,  we  see  great  difficulty  in  swallow- 
ing, and  very  often  see  an  animal  pick  up  some  indigestible  object,  at- 
tempt to  swallow  it,  and,  not  svicceeding,  drop  it  from  its  mouth.  Fre- 
quently the  animal  will  lap  out  of  his  bowl,  but  it  is  seen  if  observed 
closely  that  he  does  not  swallow  any  of  it,  on  the  other  hand  animals 
may  cower  and  draw  away  from  water  that  has  been  spilled  on  the  floor 
of  the  cage.  Vomiting  sometimes  occurs.  There  is  great  difficulty 
in  defecation,  which  seems  to  produce  evident  pain.  There  is  very  little 
alteration  in  respiration,  l)ut  it  may  Ix'  slightly  increased.     The  pulse  is 


RABIES  297 

increased;  the  temperature  also  rises,  but  falls  toward  the  end  of  the 
course  of  the  disease. 

The  duration  of  the  second  stage,  which  does  not  always  present 
all  of  the  characteristic  symptoms  of  this  condition,  may  last  from 
three  to  four  days.  After  the  paroxysms  have  increased  in  intensity 
and  the  intervals  between  them  grow  shorter,  the  paralytic,  or  last, 
stage  begins.  The  animals  rapidly  become  emaciated;  the  eyes  are 
staring,  dull,  and  the  eyeball  is  retracted  into  the  skull.  The  conjunc- 
tiva is  generally  hypersemic,  the  cheeks  are  sunken;  the  hair  is  erect; 
and  we  begin  to  see  symptoms  of  paralysis.  As  a  rule,  the  first  sign  of 
this  is  a  paralysis  of  the  muscles  that  close  or  raise  the  lower  jaw.  This 
allows  the  saliva  to  run  out  of  the  corners  of  the  mouth  and  form  threads 
which  hang  down,  and  we  easily  recognize  the  fact  that  the  tongue  and 
lower  jaw  have  lost  their  power.  The  tongue  becomes  lead-colored  and 
hangs  out  of  the  mouth.  Soon  we  see  paralysis  of  the  posterior  extrem- 
ities. This  begins  with  a  staggering,  unsteady  gait,  and  finally  total 
inability  to  use  the  posterior  half  of  the  body.  Then  the  animals  stretch 
themselves  out  and  become  completely  paralyzed,  or  in  the  last  stage 
we  may  see  convulsions,  but  that  is  very  rare.  Death,  as  a  rule,  occurs 
in  the  fifth  to  the  seventh  day  after  the  onset  of  the  disease.  In  rare 
instances  it  may  last  ten  days.  Variations  may  occasionally  occur  in 
the  regular  course  of  the  disease;  for  instance,  paralysis  of  the  posterior 
extremities  has  been  the  first  symptom  observed,  and  in  others  the 
paralysis  of  the  jaw  has  not  been  observed,  and  dyspnoea  has  been 
observed  for  hours  before  death. 

Dumb  Rabies. — The  mute  or  dumb  form  of  rabies,  according  to  Bol- 
linger, comprises  about  15  to  20  per  cent,  of  all  cases.  The  average 
given  of  this  form  of  rabies  is  entirely  too  small,  and  should  be  at  least 
50  per  cent.,  the  great  majority  of  cases  observed  being  the  dumb  form. 
This  is  distinguished  from  furious  rabies  by  the  fact  that  the  irritating 
or  nervous  symptoms  are  less  marked,  and  in  very  rare  cases  entirely 
absent,  also  that  the  paralytic  symptoms  appear  early  in  the  disease. 
First,  we  see  paralysis  of  the  muscles  of  the  lower  jaw.  The  mucus  or 
saliva  runs  out  of  the  opened  mouth,  and  an  inclination  to  bite  is  entirely 
absent,  although  under  certain  conditions  when  the  mouth  is  forcibly 
opened  the  animal  will  be  able  to  bite.  The  voice  is  also  changed,  but 
it  is  very  rarely  heard.  We  see  a  loss  of  appetite,  the  animal  being 
unable  to  seize  or  swallow  foreign  bodies.  In  this  quiet  form  the  three 
stages  follow  very  closely  on  each  other,  the  course  of  the  disease  being 
very  rapid,  and  death,  as  a  rule,  appears  in  two  or  three  days,  never 
over  five. 

These  two  forms  of  rabies  in  rare  instances  may  merge  one  into 
the  other  so  that  it  is  intensely  difficult  at  times  to  separate  the  different 


298  DISEASES  OF  TRUE  IXFECTIOX 

forms,  for  instanco  a  case  which  we  will  cite  illustrates  this.  The  affected 
animal  twenty-four  hours  l^efore  his  death  had  a  hoarse  bark,  no  appe- 
tite, and  the  muscles  of  the  mouth  appeared  normal,  he  allowed  the 
mouth  to  be  examined  and  the  tongue  pressed  down  to  see  the  throat, 
there  was  not  the  slightest  inclination  to  bite  or  show  any  signs  of  deli- 
rium or  mental  aberration;  when  the  animal  died  he  showed  great 
sexual  excitement.  On  post-mortem  the  stomach  was  found  to  contain 
hay,  straw,  as  well  as  hair  that  did  not  come  from  his  own  coat. 

This  disease  must  always  be  considered  fatal. 

The  diagnosis  of  rabies  may  be  complicated  by  certain  conditions 
present,  due  to  other  diseases.  This  is  especially  noticed  in  the  mild 
form  and  in  well-trained  affectionate  animals  which  obey  their  masters 
to  the  last.  Two  instances  in  which  the  English  setter  was  under  com- 
plete control;  hunted  in  the  field,  obeying  the  whistle  and  call  instantly, 
and  at  the  same  time  had  every  symptom  of  dumb  rabies.  Often  we 
see  cases  where  the  history  is  either  insufficient  or  the  owner  can  give 
none  at  all.  On  the  other  hand,  in  the  furious  form,  a  history,  as  a  rule, 
is  not  required,  as  the  disease  can  be  instantly  recognized  from  the 
appearance  of  the  animal.  Great  excitement-  and  restlessness,  a  ten- 
dency to  escape,  biting  and  delirious  actions,  rapid  emaciation,  and 
debility  are  characteristics  of  the  furious  form  of  this  disease,  while 
great  depression  and  paralysis  of  the  lower  jaw  are  characteristic  of  the 
dumb  form.  In  both  forms  there  is  a  great  inclination  to  gnaw  objects. 
Sexual  desire,  in  the  early  stage,  is  prominent.  A  depraved  appetite  and 
altered  l^ark,  more  or  less  rapid  symptoms  of  paralysis,  and  the  cases 
being  invariably  fatal.  The  post-mortem  confirms  the  disease  when 
we  find  acute  hypersemia  of  the  throat,  pharynx,  and  hemorrhagic 
erosions  on  the  mucous  membrane,  also  foreign  bodies,  etc.,  in  the 
stomach. 

Regarding  the  presence  of  sugar  in  the  urine  of  rabid  dogs,  that 
cannot  be  said  to  be  of  special  significance,  as  it  is  found  to  be  present 
in  other  diseases.  The  presence  of  the  corpuscles  of  Negri  in  a  suspected 
animal,  on  the  other  hand,  must  be  regarded  as  a  diagnostic  symptom  of 
great  importance,  particularly  as  it  is  a  means  of  making  a  quick  diag- 
nosis. The  horn  of  Ammon  is  where  these  corpuscles  are  found  in  the 
largest  quantities,  and  it  requires  one  to  be  thoroughly  familiar  with 
these  bodies  to  recognize  them  quickly  and  easily.  They  are 
found  in  particles  of  the  horn  of  Ammon  fixed  in  Zenker's  fluid,  and 
treated  with  a  10  per  cent,  solution  of  osmic  acid,  then  washed  thoroughly 
and  then  laid  in  absolute  alcohol;  this  method  has  the  disadvantage  of  tak- 
ing some  time  to  accomplish  it .  The  method  of  Bohne  seems  to  be  the  most 
desirable.  Mode  of  procedure:  sections  one-half  to  three-fourths  mm. 
thick  are  cut  from  the  horn  of  Ammon  and  put  in  15  c.c.  of  acetone  and 


A  SMEAR  PREPARATION  OF  THE  HIPPOCAMPUS  MAJOR  SHOWING  NEGRI  BODIES, 
STAINED  BY  THE  METHOD  OF  VAN  GIESEN,  ENLARGED  looo  DIAMETERS. 

[St-e  RaHes]. 


Pink  :     Stained  tissue. 
Blue :     Cells. 


Brick :     Negri  bodies. 
Red  :     Blood  corpuscles. 


RABIES  299 

left  at  a  tcmporatiiro  of  37°  until  they  become  hardened^  then  the  sec- 
tions are  transferred  to  liquefied  paraffine  and  left  there  for  an  hour  at  a 
temperature  of  60°,  then  the  sections  are  put  in  cold  water  to  which  a 
small  quantity  of  gum  aral3ic  is  added  and  put  in  a  stone  and  the  paraffine 
carried  off,  then  the  sections  are  colored  by  means  of  Mann's  process, 
which  is  to  put  the  sections  for  one-half  to  four  minutes  in  a  coloring 
solution  consisting  of  35  c.c.  of  1  per  cent,  aqueous  solution  of  methylene 
blue  and  35  c.c.  of  1  per  cent,  aqueous  solution  of  eosin  and  100  c.c. 
of  distilled  water.  The  sections  are  rinsed  with  water  and  then  put 
in  absolute  alcohol  for  15  to  20  seconds,  to  which  has  been  added 
some  caustic  soda  (to  30  c.c.  of  alcohol  add  5  droi>?  of  1  per  cent, 
solution  of  absolute  alcohol).  The  sections  are  again  put  in  alxsolute 
alcohol  for  a  few  moments  and  then  washed  in  water  for  a  minute;  the 
sections  are  now  put  in  water  slightly  acidulated  with  acetic  acid, 
drained  and  sealed  with  canada  balsam. 

The  following  procedure  has  been  the  method  employed  for  the 
rapid  diagnosis  of  rabies  in  the  laboratory  of  the  Veterinary  school  of 
the  University  of  Pennsylvania  for  several  years:  As  soon  as  the 
animal's  head  arrives  at  the  laboratory  the  entire  brain  and  the 
plexiform  ganglia,  with  the  adjacent  sympathetic  ganglia  are  removed. 
A  portion  of  the  cerebellum  is  placed  in  sterile  glycerine,  in  which  the 
})rain  tissue  may  be  preserved  and  retain  the  virus  for  many  weeks. 
These  glycerine-immersed  specimens  are  only  referred  to  for  the  animal 
inoculation  test  when  the  microscopic  examination  is  unsatisfactory. 
Aside  from  preventing  decomposition,  the  glycerine  will  also  destroy 
bacteria  and  check  decomposition  of  the  specimens.  From  the  fresh 
brain  tissue,  smears  are  usually  made  from  the  hippocampus  major  and 
cerebellum.  A  piece  1  mm.  thick  and  several  millimetres  in  diameter 
cut  from  the  freshly  exposed  surface,  after  an  incision  is  made  through 
the  hippocampus  major  at  right  angles  to  its  length,  or  of  the  cerebellum 
in  which  an  incision  has  been  at  right  angles  to  the  convolutions,  is 
placed  upon  a  slide  near  one  end.  Instead  of  using  a  cover-slip,  another 
slide  is  placed  over  the  small  piece  of  tissue  and  gentle  pressure  is  applied 
and  the  opposite  ends  of  the  slides  are  moved  toward  one  another.  The 
smears  are  then  placed  in  alisolute  alcohol  for  two  to  five  minutes, 
whereupon  the  alcohol  is  allowed  to  evaporate  and  the  smears  then  stained. 
The  stain  as  recommended  by  Van  Giesen  is  used. 

Loeffler's  alkaline  methylene  blue,  1  part. 

Distilled  water,  1  part. 

Saturated  alcoholic  solution  of  fuchsin  added  in  drops 
until  the  mixture  has  a  purple  tinge,  or  initil  a  metallic 
scum  is  seen  on  the  surface. 

The  mixture  kept  at  a  low  temperature  can  be  used  for  an  unlimited 


300  DISEASES  OF  TRUE  INFECTION 

length  of  time,  ])ut  it  is  apt  to  change  quickly  at  room  temperature,  and 
for  this  reason  a  new  l)atch  of  stain  is  usually  made  each  day  or  as  each 
specimen  is  prepared  for  examination.  A  smear  properly  fixed  on  a 
slide  is  taken  up  with  a  pair  of  forceps  and  completely  covered  with 
stain.  The  slide  is  passed  through  the  flame  of  a  Bunsen  burner  several 
times  until  steam  arises  from  the  heated  stain,  which  is  permitted  to 
remain  on  the  smear  for  five  to  thirty  seconds.  The  smear  is  then 
washed  in  running  water,  and  if  the  color  of  the  smear  is  blue  where  the 
brain  tissue  is  thickest,  and  red  where  the  smear  is  thin,  the  slide  is 
placed  between  filter-paper  and  dried.  As  soon  as  the  slide  is  dry  a 
search  is  made  for  large  nerve  cells  with  a  low-power  lens  under  the 
microscope.  The  protoplasm  of  the  nerve  cells  should  be  stained  a  light 
blue,  the  nucleus  a  shade  of  purple,  and  the  nucleolus  a  dark  blue.  If 
the  cells  are  stained  too  deeply  the  stain  may  be  weakened  by  the 
addition  of  more  distilled  water  or  in  heating  the  staining  fluid  on  a 
smear  for  a  longer  time,  the  intensity  of  the  staining  of  the  fuchsin  will 
be  increased  at  the  expense  of  the  blue  of  the  Loeffler's  alkaline  methylene 
blue.  "When  a  nerve  cell  is  found  properly  stained,  it  is  examined  with 
an  oil  immersion  lens.  Xegri  bodies  with  this  staining  fluid  show  the 
inner  bodies  a  bluish  black  and  the  structure  around  the  inner  bodies  a 
maroon-red.  They  are  found  within  the  cell,  outside  of  the  nucleus  of 
the  cytoplasm  in  the  nerve  cells  of  sections,  but  not  infrequently  in  the 
smear  preparations,  a  few  Negri  bodies  not  Avithin  the  nerve  cells  are 
seen,  which  have  been  forced  out  of  the  nerve  cell  as  the  smear  is  made. 
In  searching  a  smear  for  Negri  bodies,  only  those  bodies  within  the  nerve 
cells  should  be  considered. 

In  doubtful  cases  the  disease  can  only  be  accurately  diagnosed  by 
vaccination — that  is  to  say,  by  the  injection  of  small  quantities  of  horn 
of  Ammon  or  a  section  of  the  cord,  which  have  been  diluted  with  distilled 
water,  and  emulsified  and  filtered  through  fine  linen.  The  following 
methods  are  used  at  present: 

(1)  The  Intercranial  Subdural  Inoculation  (Pasteur). — The  inoc- 
ulating material  (1  or  2  drops  of  the  emulsion)  should  be  injected  into 
the  dura  mater  of  a  dog  or  rabbit,  after  it  has  been  trephined,  by  means 
of  a  small  hypodermic  syringe,  and  the  wound  sewn  up.  The  operation 
is  easily  performed,  and  is  especially  valuable  when  the  suspected  animal 
may  have  bitten  not  only  other  dogs,  but  man.  As  this  inoculation 
from  the  spinal  matter  of  a  suspected  dog  takes  at  least  two  or  three 
weeks,  sometimes  longer,  the  animal  develops  all  the  phenomena  of  the 
disease,  paralysis,  etc.,  on  the  quiet.  Leclainche  recommends  intra- 
cerebral inoculation,  that  is,  direct  injection  of  the  inoculating  substance 
into  the  brain  itself;  the  persons  bitten  should  not  delay,  while  waiting 
for  development,  but  all  measures  should  be  taken  as  soon  as  possible. 


RABIES  301 

(2)  The    Intraocular    Inoculation    (Gibier,    Nocard,    Johne). — The 

emulsion  (1  to  2  dropt^)  wliit-h  is  thus  obtained  is  filtered  through  a 
piece  of  linen  antl  injected  directly  into  the  anterior  chamber  of  the  eye 
of  the  animal  which  is  to  bo  inoculated.  They  do  this  by  means  of  a 
small  hypodermic  syringe,  having  first  placed  cocaine  on  the  cornea, 
and  then  inject  the  solution  directly  into  the  anterior  chamber.  If  the 
suspected  animal  is  raliid,  we  will  see  the  development  of  the  disease  in 
from  twelve  to  twenty-three  days,  even  if  the  chaml)er  should  suppurate 
from  the  irritation  of  the  injected  solution.  Gal  and  Klimmer  oppose 
this  procedure  by  pointing  out  the  fact  that  the  stage  of  incubation 
may  be  much  longer  than  this. 

(3)  The  Intraspinal  Method  (Labell). — The  emulsion  is  injected 
directly  in  the  cord;  this  method  takes  somewhat  longer  to  develop  than 
the  subdural  inoculation. 

(4)  Intramuscular  Inoculation. — One  c.c.  of  the  emulsion  is 
injected  into  the  masseter,  the  dorsal  or  the  posterior  crural.  Klimmer 
finds  that  the  active  symptoms  are  developed  somewhat  earlier  than  by 
the  intraocular  method. 

There  are  other  methods  of  inoculation  used  l3ut  they  are  much 
less  reliable,  such  as  nasal,  subconjunctival,  subcutaneous  and  intravenous. 

It  is  always  w^ell  to  inoculate  two  animals,  because  it  frequently 
happens  that  an  animal  is  immune  to  the  disease  or  dies  shortly  after 
the  inoculation  (cerebral  hemorrhage,  etc.). 

The  following  diseases  are  sometimes  mistaken  for  rabies:  Certain 
affections  of  the  brain,  such  as  teething,  epilepsy,  eclampsia,  distemper, 
angina,  intestinal  parasites,  inflammation  of  the  intestines,  pentastoma 
in  the  nose  and  frontal  cavities,  foreign  bodies  in  the  mouth  (between 
the  teeth)  or  in  the  throat,  paralysis  of  the  lower  jaw,  luxation  of  the 
lower  jaw,  due  to  irritation  of  the  tiigeminus,  intense  excitement  in 
latches  that  have  had  their  young  taken  from  them,  great  sexual  excite- 
ment in  male  dogs,  long  confinement  in  cages  or  kennels,  and  from 
certain  poisons.  The  course  of  the  disease,  however,  and  the  after- 
symptoms  always  enal^le  one  to  make  a  differential  diagnosis. 

Therapy  and  Prophylaxis. — As  soon  as  the  disease  has  reached  a 
point  where  there  is  no  question  as  to  its  character,  the  animal  should 
be  destroyed  as  soon  as  possible.  When  man  is  bitten  it  is  a  question 
whether  thorough  disinfection  or  cauterization  of  the  wound  is  of  much 
benefit  unless  it  is  done  within  a  few  minutes.  In  reference  to  the  pre- 
ventive inoculation  of  Pasteur,  it  is  not  necessary  to  enter  into  detail  in 
this  work,  beyond  the  fact  that  it  is  the  inoculation  of  an  attenuated  virus 
cultivated  from  rabies.  A  large  number  of  experimenters  have  made 
repeated  inoculations  with  a  view  of  obtaining  immunity  to  the  disease, 
but  they  have  not  had  very  satisfactory  results. 


302  DISEASES  OF  TRUE  INFECTION 

The  most  effective  method  of  preventing  the  spread  of  rabies  is  to 
register  all  dogs  claimed  by  owners,  and  all  stray  dogs  should  bo  destroyed, 
and  when  there  is  a  case  of  rabies  or  a  suspicion  of  such,  all  dogs  should 
be  put  under  observation,  nuizzknl  or  put  on  a  leash,  and  any  dog 
known  or  suspected  of  having  been  bitten  by  a  rabid  dog  should  be 
confined  and  watched  by  a  competent  veterinarian  and  if  found  to 
develop  the  active  symptoms  it  should  be  immediately  destroyed  and 
the  head  sent  to  the  local  live  stock  sanitary  board  laboratory  for 
examination. 

In  the  largo  cities  all  dogs,  if  they  are  worth  keeping  as  pets,  should 
be  taxed  and  all  vagrant  mongrels  taken  up  and  destroyed.  In  America 
and  England  where  they  have  made  a  close  study  of  the  spread  of  rabies 
and  have  reached  the  conclusion  that  while  muzzling  is  a  protective 
measure,  it  is  by  far  the  least  point  of  danger,  for  an  owner  that  Vvill 
take  the  trouble  to  muzzle  his  dog  is  one  who  closely  observes  his  animal 
and  at  the  first  sign  of  the  disease  has  him  examined.  Invariably  the 
outbreaks  of  disease  originate  either  in  the  slums  of  cities  or  little  villages, 
where  the  low  class  of  ignorant  shiftless  masses  live,  who  protect  and 
have  around  their  places  a  number  of  mongrel  curs  that  are  valueless; 
the  owners  or  protectors  of  these  pariahs  will  neither  observe  their  animals 
nor  restrain  them  when  they  develop  rabies,  but  drive  them  off,  or 
allow  them  to  go  on  their  travels  to  bite  and  tear  every  animal  that 
comes  in  contact  with  them.  Taxation  has  been  tested  out  in  Europe  and 
in  every  case  where  mongrels  were  gathered  up  and  destroyed  rabies 
decreased  one-half  or  more — in  some  cases  not  a  single  case  was  recorded. 

Tuberculosis. 

Under  this  name  we  class  all  affections  w^hich  owe  their  origin  to  a 
peculiar  specific  bacterium  known  as  "tubercle  bacillus,"  discovered  by 
Koch.  These  are  found  in  all  tubercular  deposits  in  man  or  in  animals, 
whether  they  occur  spontaneously  or  are  inoculated.  Under  the  micro- 
scope they  appear  in  the  shape  of  very  narrow  non-flagellated  rods  often 
slightly  curved,  fi-om  2  to  4/(  long.  The  organism  shows  many  variations 
in  its  morphology  under  different  conditions.  It  often  occurs  in  isolated 
clumps,  either  in  cultures  or  in  tissues.  In  certain  cultures  and  in  ani- 
mal tissues  it  grows  in  the  form  of  longer  or  shorter  branching  threads 
(Ricketts). 

The  tubercle  bacilli  should  be  considered  as  true  parasites  which 
multiply  and  live  in  the  body  only,  but  they  also  seem  to  possess  the 
property  of  living  outside  of  the  body  for  a  certain  length  of  time,  as 
the  excretions  of  tuberculous  animals  can  be  used  successfully  to  in- 
oculate other  animals.       ^^'e  therefore  conclude  that  tuberculosis  is  only 


TUBERCULOSIS  303 

produced  In'  infection,  or  a  better  term  would  be  transmission  of  tubercle 
bacilli,  direct  or  indirect,  from  one  subject  to  another. 

While  it  is  well  known  that  tuberculosis  of  man  and  of  certain 
domestic  animals,  such  as  cattle,  is  very  common,  it  is  rather  rare  in  dogs. 
A  number  of  schools  have  found  that  only  from  2  to  5  per  cent,  of  all  of  the 
animals  brought  to  the  clinics  were  affected  with  tuberculosis.  Dogs  seem 
to  possess  more  power  of  resistance  and  are  able  to  throw  off  the  disease. 

Certain  experiments  by  inoculation  and  inhalation  have  demon- 
strated the  fact  that  one-third  of  the  cases  develop  the  disease,  and  the 
feeding  of  tubercular  matter  in  the  food  invariably  produced  negative 
results.  Considering  the  rarity  of  this  disease  in  the  dog,  we  will  not 
give  any  detailed  explanation  of  any  length  concerning  its  etiology, 
pathological  anatomy,  etc. 

Etiology  and  Pathological  Anatomy. — A  number  of  observers  agree 
to  the  fact  that,  as  a  rule,  an  animal  affected  with  tuberculosis  has  been 
at  some  time  near  or  in  the  vicinity  of  some  person  who  was  in  an  ad- 
vanced stage  of  consumption.  In  such  cases  the  bacilli  may  be  intro- 
duced in  the  form  of  fine  dust  and  be  respired  into  the  lungs  or  may  be 
taken  up  by  the  intestines,  finding  their  way  into  the  bowels  mixed  with 
food.  In  one  ease  which  the  writer  observed  there  Avere  tuberculous 
ulcers  in  the  parotid  region,  and  also  tubercular  deposits  in  the  lymphatic 
glands  of  the  neck.  The  disease  appears  in  the  dog  in  the  form  of  an 
acute  or  local  tuberculosis.  The  disease  may  be  found  in  the  lungs, 
the  mesenteric  glands,  the  intestines,  liver,  kidneys,  and  peritoneum,  and 
in  rare  instances  affecting  the  entire  body. 

Pulmonary  Tuberculosis. — This  presents  numerous  anatomical  alter- 
ations: over  the  entire  lung  we  may  find  firm  round  gray  nodules  (miliary 
tuberculosis),  or  they  may  break  down,  forming  caseous  nodes  and 
cavernous  hollows  or  there  may  lie  a  chronic  indurated  broncho-pneu- 
monia; more  rarely  we  find  chronic  interstitial  indurating  pneumonia 
with  secondary  alterations,  acute  and  chronic  bronchitis,  peribronchitis, 
bronchiectasis,  pulmonary  hypera^mia,  emphysema,  and  frecjuently 
adherence  of  the  lung  to  the  pleural  wall. 

In  nearly  50  per  cent,  of  all  cases,  the  lymphatic  glands  of  the 
thorax,  especially  the  bronchial  glands  and  the  glands  which  are  located 
above  and  behind  the  mediastinum,  are  invariably  infected  to  a  marked 
degree  with  tubercular  deposits,  and  are  found  to  be  very  often  enlarged, 
forming  large  tumor-like  masses.  These  consist  of  a  lardaccous  tissue, 
grayish-white  in  color,  and  generally  contain  a  centre  cavity  filled  with 
a  cheese-like  mass.  True  cheesy  tuberculosis  is  rather  rare  in  the  dog, 
but,  on  the  other  hand,  we  find  a  peculiar  process  of  absorption  of  the 
tissues,  foi-ming  white  masses,  which  on  examination  are  found  to  be 
tuberculous  deposits. 


304  DISEASES  OF  TRUE  INFECTION 

Pleural  Tuberculosis. — "When  the  process  of  breaking  down,  or 
disintegration,  has  gone  on  to  any  marked  degree,  the  tuberculous 
mass  forms  a  tumor-like  body  containing  in  its  centre  a  whitish  fluid 
held  in  fibrinous  tissue.  This  was  noticed  in  50  per  cent,  of  the  cases 
observed  in  the  dog  where  the  lymphatic  glands  had  undergone  this  de- 
generation. In  the  other  half  of  the  cases,  the  serous  meml)ranes  of  the 
abdominal  cavities  were  covered  with  tubercular  masses,  the  pleura  being 
the  most  common  seat  of  the  disease.  In  the  majority  of  cases  of  pleural 
tuberculosis  it  takes  the  form  of  what  is  known  as  the  "  pearl "  tubercular 
masses.  These  are  found  to  be  deposits  of  soft  connective  tissue, 
occurring  in  the  form  of  numerous  conglomerating  granulations  or  in 
large  round  tumors.  In  some  cases  there  is  extensive  exudative  in- 
flammation present  (sero-fibrinous  and  purulent  pleuritis).  Tubercular 
inflammation  is  found  in  the  pericardium,  with  extensive  adhesion  to  the 
heart,  and  a  very  pecviliar  alteration  of  the  mediastinum  has  been 
deserved  in  several  cases.  The  heart  rarely  presents  any  tubercular 
formations. 

In  the  digestive  organs,  the  lymphatic  glands  of  the  head  and  neck 
are  rarely  invaded;  and  the  writer  found  the  submaxillary  and  retro- 
pharyngeal lymphatics  to  l)e  afTected  in  only  one  instance.  On  the 
other  hand,  the  mesenteric  glands  were  particularly  affected,  some  cases 
presenting  large  tumor-like  masses  containing  broken-down  centres. 

Tuberculosis  of  the  intestines  is  rare,  and  is  restricted  to  slight 
ulcerations  or  abscesses.  The  liver,  as  a  rule,  is  generally  involved  to  a 
marked  degree,  its  substance  being  filled  with  small  nodules  or  large 
granular  masses  which  are  milky  W'hite  in  color.  In  the  centre  of  these 
is  found  a  broken-down  opaque  fluid,  the  result  of  fatty  degeneration. 
The  spleen  was  found  by  the  writer  to  be  tubercular  in  two  cases,  and  that 
only  to  a  slight  degree.  In  the  liver  are  found  numerous  firm  white 
fibrous  nodules  ranging  from  the  size  of  a  pea  to  the  size  of  an  egg.  The 
kidneys  are  frequently  the  seat  of  more  or  less  tubercular  deposits,  and 
in  twelve  cases  scattered  granulations  were  found  in  the  spinal  and  mem- 
branous substance,  but  cheesy  abscesses  and  centres  were  also  found. 
These  were  accompanied  by  chronic  indurative  nephritis.  Ulceration  of 
the  pelvis  of  the  kidney  w^as  observed  in  one  case.  One  dog  showed  Init 
a  slightly  tubercular  ureter  and  bladder.  The  sexual  organs  are,  as  a 
rule,  found  healthy  and  very  rarely  attacked  by  the  disease.  In  rare 
instances  a  tubercular  testicle  is  noticed. 

Tuberculosis  of  the  prostate  has  been  o]:)served,  also  in  the  ovary, 
the  bones,  articulations  and  in  the  brain.  A  tuberculous  ulceration  of 
the  skin  has  also  been  seen.  For  further  particulars  as  to  the  patho- 
logical character  of  tuberculosis,  consult  the  numerous  works  on  the 
subject. 


TUBERCULOSIS  305 

Clinical  Symptoms  and  Course. — On  account  of  the  various  ways 
in  which  tuborcuhj.sis  ai)])ears,  no  postive  line  of  symptoms  can  be  made. 

Acute  miliary  Tuberculosis  is  very  rare  and  runs  its  course  with 
intense  rapidity,  and  generally  it  is  only  by  the  presence  of  the  tuber- 
cular bacilli  in  the  blood  that  it  can  be  recognized. 

Chronic  Tuberculosis. — The  animal  is  easily  fatigued,  short  breath, 
particularly  after  any  slight  exertion,  irregular  appetite,  there  is  a  dry 
hollow  cough,  generally  on  rising  after  resting  or  after  eating,  later  the 
cough  becomes  more  frequent  and  painful,  and  there  may  be  a  muco- 
purulent discharge  from  the  nose,  difficulty  in  respiration — this  at  first 
is  slight,  but  sooner  or  later  it  is  very  pronounced;  on  auscultation 
there  is  a  vascular  murmur,  and  later  bronchial  rales  of  diverse  forms  and 
intensity;  later  a  pleuritis  and  a  hydrothorax.  Valuable  animals  pre- 
senting these  symptoms  may  have  the  diagnosis  made  positive  by  in- 
oculating a  rabbit  (intraperitoneally)  with  the  pleural  exudate,  and  if 
the  exudate  was  tubercular,  three  weeks  afterward  the  spleen  and  the 
peritoneum  of  the  rabbit  will  show  the  tubercular  lesions,  or  w^e  find  a 
tubucular  mass  on  the  liver. 

Tuberculosis  of  the  lungs  only  will  show  marked  symptoms  after 
it  has  made  considerable  progress,  and  as  the  symptoms  are  ver}^  similar 
to  chronic  catarrh  of  the  lungs  or  chronic  lobular  pneumonia,  it  is  apt 
to  be  confounded  with  these  two  diseases  (see  this  disease).  Notwith- 
standing a  good  appetite,  when  there  is  rapid  emaciation  and  a  quick 
loss  of  strength  we  should  suspect  the  animal  has  tuberculosis  of  the  lungs 
but  we  can  only  be  positive  of  our  diagnosis  by  recognizing  the  tubercle 
bacilli  in  the  secretions,  although  it  is  very  difficult  to  find  the  bacilli  as 
it  is  not  only  extremely  difficult  to  obtain  sputa  from  a  dog,  but  to  find 
the  bacilli  if  we  do  get  some  of  the  sputa  (see  later,  tuberculin  test). 

Tuberculosis  of  any  of  the  abdominal  organs  is  very  difficult  to 
recognize.  The  only  way  we  might  succeed  is  by  manipulation  of  the 
abdominal  cavity,  recognizing  swollen  lymphatic  glands  or  tubercular 
masses  on  the  liver.  We  do  find,  however,  great  emaciation  and  symp- 
toms of  chronic  catarrh  of  the  intestinal  tract.  These  last  two  symptoms 
are  generally  sufficient  to  make  us  suspect  intestinal  tuberculosis.  In 
one  case  of  tubercular  ulceration  of  the  intestines  which  was  observed 
by  the  writer,  the  dog  was  very  thin  and  had  shown  this  emaciation  for 
some  time.  There  were  also  present  symptoms  of  catarrh  of  the  lungs, 
and  upon  the  upper  portion  of  the  neck  a  deep  abscess  had  formed. 
This  was  ciuite  large  and  contained  ciuantities  of  thin  pus.  In  the  region 
of  the  neck  near  the  abscess  we  observed  a  granular  mass  the  size  of  a 
chestnut.  This  could  be  pushed  under  the  cutaneous  membrane  and 
moved  about  freely.  There  were  also  present  a  few  enlarged  lymphatic 
glands  in  the  upper  portion  of  the  neck. 

20 


306  DISEASES  OF  TRUE  INFECTION 

A  very  important  and  constant  symptom  of  tuberculosis  is  the  grad- 
ual emaciation  of  the  affected  animal,  accompanied  by  exhaustion  on 
the  slightest  exertion,  the  hair  is  hard,  dry  and  bristly,  the  eyes  are 
sunken,  the  face  drawn  and  wrinkled,  the  visible  mucous  membranes 
pale  or  yellowish,  the  mucous  membranes  are  dry,  the  pulse  small, 
accelerated,  and  the  heart  throbs,  the  temperature  is  elevated  from 
time  to  time,  the  appetite  is  irregular  but  generally  small,  constipation 
alternates  with  obstinate  diarrhoea,  and  finally  the  animal  becomes  a 
skeleton  and  dies  in  a  state  of  collapse;  at  this  stage  the  temperature  is 
apt  to  be  subnormal.  The  average  duration  of  the  disease  is  from  six  to 
eight  months. 

Microscopical  Demonstration  of  the  Tubercle  Bacilli. — The  tubercular 
matter  is  placed  on  a  glass  and  allowed  to  dry  in  the  air;  it  is  then  covered 
with  Ziehl's  carbol  fuchsin  solution  (1.0  fuchsin,  10.0  absolute  alcohol,  5.0 
carbolic  acid,  95.0  distilled  water)  and  heated  over  the  flame  for  two 
minutes.  Then  it  is  allowed  to  cool,  then  washed  with  distilled  water 
and  then  put  in  Gabbet's  solution  (2.0  methylene  blue,  100.0  of  25  per  cent, 
solution  of  sulphuric  acid) ;  after  lying  in  this  for  two  minutes  it  is  rinsed 
with  water  and  is  ready  for  examination.  The  tubercle  bacilli  are 
stained  red,  the  other  substances  being  blue;  an  oil  immersion  lens  gives 
the  best  results.  Where  the  examination  must  be  made  as  soon  as  pos- 
sible, if  the  preparation  is  thoroughly  dried,  it  gives  almost  as  good 
results  (see  Plates). 

Tuberculin  Test. — The  inoculation  of  Koch's  tuberculin  to  deter- 
mine whether  a  dog  is  affected  with  the  disease  may  be  tried,  but  as  a 
rule  is  unsatisfactory,  the  reaction  is  seldom  very  pronounced  in  char- 
acter, and  in  the  acute  stages  of  the  disease  it  may  even  give  a  subnormal 
temperature;  in  several  instances  an  animal  gave  a  reaction,  but  careful 
examination  failed  to  give  any  evidences  of  tuberculosis.  Recently  the 
ophthalmic  test  has  come  into  popular  favor  in  diagnosing  tuberculosis 
in  the  dog.  The  method  is  quite  simple.  It  consists  in  dropping  into 
the  conjunctival  sac  1  or  2  drops  of  tuberculin,  especially  prepared  for 
this  test.  If  the  animal  is  suffering  from  tuberculosis,  a  reaction  will  be 
manifest  by  the  development  of  a  conjunctivitis  in  from  eight  to  twelve 
hours.  There  will  be  excessive  lachrymation,  injection  of  the  capil- 
laries of  the  conjunctiva  and  even  slight  suppuration  at  the  inner 
canthus.  In  chronic  cases  the  reaction  may  be  overlooked  unless  the 
animal  is  kept  under  close  observation,  inasmuch  as  the  acute  symp- 
toms come  on  and  pass  off  very  rapidly.  In  cases  of  recent  infection 
the  reaction  may  last  for  at  least  twenty-four  hours. 

Therapeutic  Treatment. — When  you  have  once  established  the  fact 
that  the  aninuil  is  aff(H-t(Ml  with  the  disease,  it  is  the  duty  of  the  veterin- 
arian to  warn  the  owner  of  the  tubercular  or  suspected  dog,  of  the  danger 


HEMOGLOBINURIA  AND  PIROPLASMOSIS 


307 


of  infection,  and  advise  him  to  destroy  the  animal.  In  the  early  stages 
of  the  disease  and  when  there  are  no  other  animals  kenneled  with  it, 
the  animal  can  be  fed  with  highly  nutritious  food  and  given  inhalations 
of  creolin  or  l^enzoin. 


Hemoglobinuria  and  Piroplasmosis. 

When  there  is  any  decomposition  of  red  corpuscles  in  the  body 
(hemogiol)inannia)  the  coloring  substance  is  eliminated  through  the 
kidneys,  staining  the  urine  and  producing  hemoglobinuria.  In  this 
condition  the  urine  is  characterized  by  a  dark  red,  dirty  brownish  or 
brick-red  coloration. 

This  condition  occurs  when  from  some  cause  the  coloring  matter 
of  the  blood  becomes  liberated,  either  from  destruction  of  the  blood 
corpuscles  or  separation  of  the  coloring  matter  from  the  stroma  of  the 
corpuscle  or  a  delixiviation  of  the  erythrocytes.  If  only  a  small  quantity 
of  coloring  matter  is  freed  it  is  taken  up  by  the  liver,  but  if  a  large 


Fig.  99. —  Blood  of  a  clog  affected  with  piroplasma  canis,  magnified  350  times.      (Kastner.) 

quantity  is  free  in  the  circulation,  it  is  also  taken  up  by  the  urine. 

The  hemoglobin  test  consists  of  drying  a  certain  quantity  of  urine  in 
a  small  saucer,  and  with  the  dry  mass  we  mix  a  small  quantity  of  finely 
pulverized  chloride  of  sodium,  placing  it  on  a  plate.  Then  add  two 
drops  of  cold  glacial  acetic  acid.  Now  slowly  heat  the  cup  over  an  alcohol 
lamp  and  allow  it  to  cool.  As  it  does  so,  you  will  see  a  quantity  of  dark- 
brown  crystals.  If  these  are  not  easily  distinguished  by  the  eye,  they 
are  with  a  magnifying  glass.  While  we  cannot  distinguish  the  presence 
of  the  coloring  matter  of  the  blood  in  the  urine  with  the  aid  of  the  micro- 
scope, we  may  detect  the  presence  of  blood  corpuscles  in  the  fluid.  Wo 
may  also  find  by  this  means  uric  casts  and  epithelium  of  the  kidneys,  and 
small  red  granulations.  These  may  be  considered  hiemoglobin.  As  to 
the  causes  of  this  condition  we  will  mention  piroplasma. 


308  DISEASES  OF  TRUE  INFECTION 

Piroplasma  Canis,  Malignant  Jaundice. — This  is  an  infectious, 
not  contagious  disease,  due  to  the  presence  of  a  protozoon,  piroplasma 
canis,  in  the  red  corpuscles;  this  disease  is  generally  found  in  warm 
climates,  particularly  South  Africa;  it  is  very  rare  in  Europe. 

Etiology. — The  cause  of  this  disease  was  first  described  JDy  Plana  and 
Gali-Valerio  as  a  protozoon  of  the  order  of  hemosporidia,  and  was  carried 
into  the  blood  of  the  dog  by  means  of  ticks — in  France  by  the  Dermacenter 
reticulatus,  in  South  Africa  by  the  Hemophysalis  leachi,  and  in  Germany 
and  Hungary  by  the  Ixodis  ricinus  reduvious.  The  disease  appears 
about  thirty-six  hours  after  infection  of  the  red  blood  corpuscles;  the 
corpuscle  being  colorless,  the  protozoa  can  easily  be  recognized  if  the 
blood  is  fixed  with  absolute  alcohol  and  stained  with  methylene  blue  (Fig. 
99).  The  size  of  the  parasite  varies  from  0.7  to  3.4/i.  They  multiply 
very  rapidly,  particularly  when  the  fever  is  high.  After  the  destruction 
of  the  erythrocytes,  the  parasites  appear  in  the  plasma,  and  are  more 
rounded  in  form,  and  then  they  appear  in  greater  numbers  in  the  in- 
ternal organs,  particularly  in  the  lung  tissue,  than  in  the  blood.  Trans- 
mission, either  by  subcutaneous  or  intermuscular  injection  of  the  de- 
fibrinated  blood  containing  the  parasites,  reproduces  the  disease  and 
the  animals  die  in  a  week;  recoveries  are  very  rare.  The  blood  if  kept 
in  a  cool  place  retains  its  full  activity  for  twenty-five  days,  in  warm 
weather  the  infected  blood  loses  its  activity  in  fourteen  days,  at  a 
temperature  of  44°  it  loses  its  power  in  one  and  one-half  hovirs,  and  at  50° 
in  one-half  hour.  Young  dogs  seem  more  receptive  of  the  disease 
than  older  animals;  bitches  which  have  had  the  disease  give  their 
puppies  a  certain  amount  of  immunity  from  the  disease. 

Pathological  Anatomy. — If  the  disease  is  very  acute,  and  runs  a 
short  course,  with  the  exception  of  the  alteration  of  the  blood,  very  little 
change  is  noticed.  In  more  gradual  cases  there  is  anaemia,  jaundice  and 
great  enlargement  in  the  volume  of  the  spleen — it  is  frequently  found 
to  be  four  times  its  natural  size — hypersemia  of  the  liver,  kidney  and 
marrow  of  the  bones,  extravasations  in  the  pericardium  and  in  the  lungs, 
catarrh  of  the  stomach  and  of  the  intestines,  especially  the  duodenum. 
In  the  kidneys,  spleen,  marrow  of  the  bone,  as  well  as  the  blood, 
numerous  piroplasma  are  found. 

Clinical  Symptoms. — The  disease  occurs  in  both  acute  and  chronic 
forms.  The  acute  form  is  ushered  in  by  listlessness,  depression,  want 
of  appetite,  and  increase  of  temperature  to  40-43°,  and  a  few  days 
later  by  a  rapid  fall  of  temperature  to  sulmormal;  the  visible  mucous 
membranes  are  cyanotic,  sometimes  yellow,  icteric;  the  pulse  and 
respirations  are  increased  and  frequently  labored;  the  gait  sluggish 
and  staggering,  and  finally  there  is  complete  paralysis.  The  urine  con- 
tains albumin  and  biliary  i)igment,  and  in  the  majority  of  cases  from 


TETANUS  309 

3  to  5  per  cent,  of  haemoglobin.  The  blood  is  thin,  light  red,  and  coagulates 
very  slowly;  the  number  of  erythrocytes  is  diminished  by  half, 
and  the  leukocytes  are  greatly  increased  in  number.  Death  occurs  in 
from  three  to  ten  days. 

In  the  chronic  form  the  temperature  is  slightly  increased  or  may  even 
remain  normal,  the  animal  shows  great  muscular  weakness,  lassitude, 
want  of  appetite  and  rapid  emaciation,  urine  contains  albumin  and 
biliary  pigment,  while  haemoglobin  is  rarely  found,  and  there  is  a  diminu- 
tion of  the  red  blood  corpuscles  and  a  corresponding  increase  of  the  white 
corpuscles.  The  duration  of  this  disease  is  from  three  to  six  weeks; 
recovery  is  not  at  all  rare.  The  diagnosis  is  easily  ascertained  by  the 
presence  of  the  piroplasma  in  the  blood.  Nocard  suggests  that  where 
there  is  every  evidence  of  the  disease,  but  microscopical  examination 
fails  to  detect  the  piroplasma,  a  young  animal  should  be  inoculated 
experimentally. 

Therapeutics. — As  there  is  no  specific  agent  that  can  be  said  to 
have  any  beneficial  effect  on  the  disease,  we  must  give  good  nursing, 
careful  but  nutritious  diet.  When  animals,  particularly  hunting  dogs, 
are  taken  to  regions  infested  with  ticks,  such  as  woods,  wet  swampy 
ground,  or  low  scrub  pasture,  the  animals  should  be  rubbed  with  emul- 
sions of  lysol,  creolin  or  petroleum  to  protect  them  from  invasions  of  the 
tick. 

Preventive  Inoculation. — When  a  dog  has  overcome  the  disease 
and  become  immune,  the  l^lood  of  this  animal  possesses  the  property 
of  destroying  the  piroplasma;  these  immune  animals  are  inoculated 
repeatedly  with  the  virulent  blood,  and  a  serum  is  obtained  w^hich  is 
used.     Care  must  be  taken  to  see  that  this  serum  retains  its  activity. 

Tetanus. 

(Lockiaw.) 

This  is  a  specific  infectious  disease  characterized  by  tonic  muscular 
contractions  and  caused  by  the  tetanus  bacilli.  These  organisms  are 
rather  long,  slender — from  two  to  four  microns  long — with  a  globular  spore 
at  the  end;  this  is  larger  than  the  bacillus  and  gives  the  latter  a  drumstick 
shape.  The  organism  is  strictly  an  anaerobe  and  is  obtained  in  pure  cul- 
ture with  some  difficulty;  morphologically  it  is  difficult  to  distinguish  from 
the  bacilli  of  malignant  oedema  and  systematic  oedema  (Ricketts) .  These 
spores  possess  great  powers  of  resistance  and  are  found  in  soil,  particularly 
in  garden  earth  and  rich  meadows,  and  in  the  excrement  of  healthy 
horses,  dogs,  cattle  and  other  animals;  this  explains  why  animals  are 
so,  prone  to  develop  the  disease  from  wounds  of  the  extremities,  tail,  etc. 


310 


DISEASES  OF  TRUE  INFECTION 


"\Micn  these  microbes  invade  a  wound  they  midtiply  with  great  rapidity 
and  produce  toxines  which  cause  a  strychnine-like  convulsive  contraction 
of  the  muscles.  The  virulence  of  the  bacilli  is  in  all  probability  influenced 
by  the  simultaneous  invasion  of  other  germs. 

This  very  rarely  occurs  in  the  dog.  The  figure  here  presented  (Fig. 
100)  is  the  only  one  the  writer  has  seen,  and  was  taken  twenty-four 
hours  l:)efore  death;  the  muscles  w^ere  contracted  to  such  an  extent 
that  the  animal  could  be  lifted  bodily  by  holding  up  one  anterior  limb. 
Tetanus  may  originate  from  a  wound  in  any  part  of  the  body.  No  special 
class  of  wound  can  be  said  to  be  favorable  to  the  production  of  tetanus. 


Fig.   100. — Dog  with  tetanus. 


It  may  originate  from  a  scratch  or  from  a  very  large  wound.  The 
temporary  trismus  seen  in  young  animals  that  have  eaten  decayed  meat 
should  be  classed  under  ptomaine  poisoning,  and  not  under  tetanus. 
The  anatomical  examination  is  almost  always  negative;  hypera^mia 
and  congestion  of  the  cord  which  is  occasionally  seen  is  of  secondary 
importance  as  it  seems  to  have  no  actual  bearing  on  the  true  cause  of  the 
disease. 

Symptoms. — The  period  of  inctd)ation  in  a  dog  is  not  known  posi- 
tively, as  the  cases  are  so  rare,  but  probably  it  is  about  the  same  as  a 
horse — from  five  to  twenty  days — depending  probably  on  the  vir- 
ulence of  the  bacilli.  The  general  symptoms  are  stiff  stilty  gait,  the  neck 
and  head  are  extended,  the  expression  is  staring  and  anxious,  the  ears  are 
drawn  forward  and  pointed,  the  membrana  nictitans  is  draw^n  over  the 
eye,  wrinkling  of  the  skin  of  the  f9rehead,  retraction  of  the  angle  of  the 


TETANUS  311 

mouth,  with  difficulty  in  eating  and  drinking,  the  penis  is  erect  and  the 
muscles  of  the  body  are  hard  and  outlined,  the  animal  is  nervous  and 
anxious;  the  pulse  and  temperature  are  generally  little  altered.  In  one 
case  there  was  an  elevation  of  temperature;  the  case  recovered.  The 
duration  of  the  disease  is  about  a  week,  but  it  may  vary.  As  recoveries 
are  recorded  from  time  to  time,  it  cannot  be  regarded  as  always  incurable. 

Therapeutics. — The  treatment  is  generally  palliative.  The  wound 
must  be  examined  and  treated  with  antiseptics,  and  use  such  sedatives 
as  morphine,  dilute  hydrocyanic  acid,  chloral;  it  must  be  remembered 
the  most  important  matter  is  to  keep  up  the  animal's  strength  with 
easily  digested  food — scraped  meat,  beaten  up  eggs.  Where  the  trismus 
makes  it  impossible  to  administer  food  by  the  mouth,  it  should  be  given 
in  the  form  of  nutritive  clysters. 

Tetanus  antitoxin  may  be  tried;  the  dose  is  5  c.c.  daily. 


CONSTITUTIONAL  DISEASES. 

Anaemia  and  Chlorosis. 

By  ansemia  in  the  strict  sense  of  the  word,  we  mean  a  lessening  or 
thinning  of  the  blood.  This  is  especially  noticeable  after  great  hemor- 
rhages. At  the  same  time  much  greater  importance  must  be  placed  on 
that  condition  of  the  blood  where  the  number  of  red  corpuscles  is  very 
much  decreased.  This  diminution  of  the  number  of  red  blood  corpuscles 
is  the  most  important  form  of  anaemia. 

Etiology. — The  disease  occurs  frequently  in  young,  delicate  animals 
of  the  improved  or  closely  bred  classes,  in  animals  that  are  weaned  too 
early,  or  when  they  are  not  properly  nourished  when  puppies.  It  seems 
to  be  hereditary  in  some  of  these  animals — litters  from  feeble,  delicate 
bitches — and  may  depend  to  a  certain  extent  on  the  defective  development 
of  the  arterial  system  and  an  abnormally  small  heart.  Anaemia  occurs 
most  frequently  from  the  lessening  in  c^uantity  of  the  vital  fluids,  such  as 
the  albuminous,  or  after  a  large  or  long-continued  slight  hemorrhage; 
from  prolonged  suppuration  of  the  kidneys;  and  lastly  a  want  of  proper 
nutrition — for  instance,  young  animals  in  a  poor  condition  should  be  fed 
on  meat.  Very  often  impaired  digestion  prevents  an  absorption  of 
certain  nutritive  substances  in  chronic  disease,  in  fever,  intestinal  worms, 
dochmius,  taeniae  or  ascarides,  or  parasites  in  the  blood  (filaria),  piro- 
plasma,  and  from  certain  poisons  in  the  blood,  etc. 

Clinical  Symptoms. — The  symptoms  of  the  disease  consist  in  a  re- 
duction of  the  coloring  elements  of  the  blood  and  a  general  condition 
of  debility,  showing  every  indication  of  loss  of  blood.  The  skin  and 
visil:)le  mucous  membranes  are  very  pale  in  color. 

The  animals  are  easily  fatigued  and  have  a  draggy  w^ay  of  walking; 
the  pulse  is  often  small  and  generally  rapid.  The  temperature  in  many 
cases  is  below  normal;  in  other  cases  it  may  be  normal  or  even  higher. 
Auscultation  of  the  heart  at  times  gives  a  soft,  booming,  systolic  murmur. 
The  respiration  is  increased  with  the  pulse,  and  especially  after  very 
slight  physical  exercise.  Reflex  excitability  of  the  brain  in  anaemic 
subjects  is  increased  to  such  an  extent  that  the  animal  will  go  into  con- 
vulsions on  the  slightest  provocation.  Impaired  digestion  is  a  frequent 
symptom  and  naturally  assists  in  complicating  the  disease.  It  is  gen- 
erally chronic,  but  proper  treatment  will  often  produce  very  good 
results. 

312 


LEUKAEMIA  313 

Therapeutic  Treatment. — The  treatment  must  all  tend  to  one 
object — that  is,  the  formation  of  more  blood.  This  may  be  obtained 
by  proper  hygienic  measures,  feeding  with  light,  easily  digested  sub- 
stances, especially  meat  (not  milk,  which  does  not  agree  with  the  animals 
for  any  length  of  time),  as  well  as  medicinal  substances — that  is  to  say, 
ferruginous  preparations.  Among  the  latter,  carbonate  of  iron,  saccha- 
rated  oxide  of  iron,  and  lactate  of  iron.  These  should  be  given  in  0.4 
to  0.5  gramme  three  times  daily.  Tincture  chloride  of  iron,  10  to  20 
drops  daily.  In  many  cases  these  iron  preparations  do  not  agree  well 
with  the  patients,  as  the  drug  irritates  the  stomach  and  their  appetite 
becomes  impaired.  These  preparations  should  have  some  vegetable 
tonic  added  to  them,  the  bitter  principle  stimulating  digestion  and 
counteracting  the  irritant  effect  of  the  iron.  A  very  useful  preparation 
in  this  disease  is  citrate  of  quinine  and  iron.  This  preparation  is  valu- 
able not  only  for  the  iron  it  contains,  but  the  tonic  properties  of  the 
quinine,  and  also  the  very  slight  tendency  it  has  to  irritate  the  stomach. 
Arsenic,  either  in  the  form  of  Fowler's  solution  or  the  red  sulphide,  is 
useful  as  a  general  tonic. 

Leukaemia. 

This  disease,  which  is  generally  chronic,  is  one  that  is  characterized 
by  an  altered  condition  of  the  blood,  due  to  the  presence  of  an  increased 
quantity  of  white  blood  corpuscles,  which  is  the  result  of  some  path- 
ological change  in  the  blood-forming  organs,  viz.:  the  lymphatic  glands, 
spleen,  and  marrow  of  bones.  Formerly  the  disease  was  classified  in 
three  divisions:  Lymphatic,  lineal  and  myelogenic  forms;  according  to 
the  origin  of  the  disease,  the  lymphatic  glands,  the  spleen  or  the  marrow 
of  the  bones.  This,  however,  is  now  classified  by  Ehrlich  into  two 
chief  divisions,  namely  (1)  lymphatic  leukaemia,  which  is  the  result  of 
some  pathological  change  in  the  lymphatic  glands  and  causes  the  appear- 
ance in  the  blood  of  numbers  of  lymphocytes,  i.e.,  isolated  cells  the  size 
of  a  red  l)lood  corpuscle,  and  (2)  myelogenic  leukaemia  in  which  thereis  some 
pathological  activity  of  the  marrow  of  the  bones  in  which  there  is  an 
enormous  increase  of  the  ordinary  polynuclear  leukocytes  and  also 
large  mononuclear  cells  which  are  only  found  in  the  marrow  of  bones. 
These  distinctions  are  of  no  special  value  to  the  practitioner,  and  both 
these  forms,  as  a  rule,  are  combined  in  the  dog  as  in  other  domestic 
animals.  The  myelogenic  form  has  never  been  observed  alone  (Seidam- 
grotsky  and  others). 

Etiology. — The  cause  of  this  disease  is  not  definitely  known  at  present. 
In  the  human  race  we  find  that  middle-aged  men  are  mostly  affected 
with  the  disease;  in  the  dog,  while  the  middle  or  advanced  period  of  age 


314  CONSTITUTIONAL  DISEASES 

seems  to  show  the  greatest  number  of  cases,  still  young  animals  are 
frequently  attacked,  and  the  disease  invariably  runs  an  acute  course. 
It  is  apt  to  follow  certain  traumatisms,  but  whether,  in  dogs,  it  follows 
as  a  result  of  grave  infectious  disease  is  a  question.  Attempts  to  produce 
the  disease  by  transfusion  of  leukaemic  blood  in  healthy  animals  gave 
negative  results  but  produced  a  swelling  of  the  gians  penis  and  the 
lymphatic  glands  in  its  immediate  neighborhood,  and  catarrh  of  the 
prepuce. 

Pathological  Anatomy. — The  most  important  alteration  always 
observed  in  this  disease  is  an  increase  of  white  blood  corpuscles  and  a 
lessening  of  the  amount  of  the  red  corpuscles  in  the  blood.  This  may 
become  so  great  in  the  dog  that  we  find  the  proportion  of  white  to  red 
blood  corpuscles  is  1  to  5  (Bollinger).  "We  find  the  blood  possesses  a 
much  lighter  color  than  it  does  normally,  has  a  lighter  specific  gravity. 
We  also  notice  a  great  tendency  to  emaciation  and  a  characteristic 
alteration  of  the  spleen,  which  is  greatly  enlarged,  and  increased  pro- 
portionately in  weight.  It  is  not  rare  to  find  it  weighing  at  least  1000 
grammes,  and  we  find  on  section  of  the  enlarged  spleen,  marks  of 
true  hyperplasia.  Fenereissen  found  in  a  bulldog  affected  with  this 
disease  a  spleen  that  weighed  3  kilogrammes.  We  also  see  at  times 
enlargement  of  the  lymphatic  glands  due  to  circumscribed  hyperplasia 
of  the  glandular  tissues.  The  marrow  of  the  bones  is  occasionally 
involved  and  appears  dark  red.  In  serious  cases  the  color  is  yellowish- 
gray,  becoming  soft  and  plastic.  In  very  rare 
cases  hyperplasia  is  seen  in  other  organs,  such  as 
the  tonsils,  liver,  and  lungs. 

Clinical  Symptoms  and  Course. — The  symp- 
toms of  the  disease  are  similar  to  those  of  intense 
anaemia.  First,  there  is  a  characteristic  alteration 
of  the  blood,  and,  second,  the  symptoms  presented 
by  the  spleen  and  lymphatic  glands.  In  mild 
Fig.  101.— The  blood  in       cases  a  microscopic  examination  of  the  l^lood  and 

leukocythaemia.  .  <■  i  i         i  mi  • 

counting  the  number  of  blood  corpuscles  will  insure 
a  diagnosis.  The  best  way  to  obtain  a  small  quantity  of  blood  for  the 
purpose  of  making  an  examination  is  to  make  a  slight  slit  in  the  upper 
surface  of  the  outside  of  the  ear.  Place  it  under  the  microscope  without 
adding  any  other  substance  to  it,  and  we  will  recognize  not  only  an 
enormous  increase  in  the  number  of  white  blood  corpuscles,  but  a  differ- 
ence in  their  normal  size  (Fig.  101). 

While  we  may  be  able  to  correctly  diagnose  the  disease  from  the 
condition  of  the  blood  during  life,  we  may  also  notice  certain  alterations 
in  the  size  of  the  spleen  and  lymphatic  glands.     In  the  glands  of  the" 
head  and  neck  we  frequently  find  considerable  enlargement.     Normally, 


LEUK.^MIA  315 

the  proportion  of  blood  corpuscles  in  the  blood  is  one  white  l)lood  cor- 
puscle to  three  or  four  hundred  of  the  red  blood  corpuscles,  but  in 
leukiemia  the  proi)0]'tion  is  frequently  one  white  to  fifty  red  nnd  in 
extreme  cases  one  to  five.  In  making  a  count  of  the  white  l)lood  cor- 
puscles there  is  one  point  that  must  not  be  forgotten,  and  that  is  that 
there  is  a  normal  physiological  increase  of  the  white  blood  corpuscles 
when  the  animal  has  had  a  great  loss  of  blood,  immediately  after  the 
digestion  of  a  heavy  meal,  where  there  is  chronic  inflammation  and 
suppuration  and  in  the  bitch  during  pregnancy;  hence  a  marked  increase 
in  the  number  of  white  blood  corpuscles,  unless  there  are  other  symptoms 
that  confirm  it,  does  not  mean  the  animal  has  leukaemia.  The  altera- 
tion in  the  lymphatic  glands  is  easily  detected  in  those  glands  that  are 
near  the  surface  of  the  body.  The  lymphatic  ganglions  are  found  to  l)e 
enlarged,  round,  and  sometimes  irregular  and  are  generally  painless  on 
pressure.  In  some  cases  we  may  find  solitary  enlarged  lymphatics  in 
different  parts  of  the  body.  Frequently  the  region  of  the  enlarged 
lymphatics  is  oedematous.  It  is  only  when  the  spleen  has  reached  a 
considerable  size  that  it  can  be  outlined  by  palpation  of  the  abdomen. 
Another  symptom  of  leukaemia  is  the  marked  increase  in  the  pulse. 
There  is  redness  of  the  mucous  meml^ranes  oi  the  mouth,  coated  tongue, 
disordered  stomach,  irregular  attacks  of  diarrhoea,  dropsical  swellings, 
ascites  or  chyle  stasis,  as  a  result  of  the  acute  hypertrophy  of  the 
abdominal  lymphatic  glands,  and  we  may  occasionally  see  intestinal 
haemorrhage. 

The  course  of  this  disease  is  invariably  chronic  with  a  gradual 
increase  of  the  severity  of  the  symptoms,  the  condition  of  the  animal 
continually  getting  worse  until  finally  the  animal  dies  of  exhaustion. 

Therapeutics. — The  treatment  of  leukaemia  is  practically  the  same 
as  that  of  anaemia.  Give  very  nutritious  food  and  arsenic,  iron  or 
quinine.  The  inhalation  of  oxygen  as  well  as  the  transfusion  of 
blood  recommended  in  the  treatment  of  this  disease  in  man  has  been 
tried  in  the  dog  and  found  unsatisfactory.  The  administration  of  certain 
organic  therapeutical  preparations,  such  as  spleen  (lienaden)  tablets, 
lymphatic  gland  tablets,  or  bone-marrow  tablets,  has  also  been  found 
to  be  valueless. 

I^.        Ferri  et  quininse  citratis,  0.2 

Saccharum,  O.G 

M.  F.  pulv.  divid  charta,  No.  xx. 

Sig. — One  jjowder  three  times  daily. 

Pseud oleukaemia.  Lymphadenia,  Hodgkin's  Disease. — This  disease 
appears  more  frequently  in  the  dog  than  leukaemia.  It  is  due  to  a 
hyperplasia    of    the  blood-forming  centres,  particularly  the  lymphatic 


3 1 G  CONS  TI T  U TIONA  L  DISEASES 

glands;  these  become  greatly  enlarged.  The  proportion  of  white  over 
red  blood  corpuscles  is  also  greatly  increased.  Cadiot  found  four  cases 
where  the  proportion  was  1  to  183  to  1  to  200.  The  cause  of  this  disease 
has  not  been  clearly  demonstrated.  Some  observers  ascribe  it  to  tuber- 
cular processes  in  the  lymphatics.  The  course  is  generally  rapid,  and 
while  in  the  early  stages  there  is  no  great  alteration  in  the  general  con- 
dition; anaemia  soon  commences,  and  in  consequence  of  the  hyperplasia 
of  the  bronchial  lymphatics  we  find  dyspnoea,  and  as  a  result  of  the 
abdominal  glands  being  in  the  same  state  of  hyperplasia  we  have 
dropsy  of  the  abdomen,  later  general  cedema,  and  finally  death. 

Treatment  is  the  same  as  anaemia  and  leukaemia.  Arsenic  is  gen- 
erally used;  if  it  has  no  effect,  iodide  of  potassium. 

Diabetes  Mellitus. 

Etiology. — By  diabetes  mellitus  we  understand  a  peculiar  chronic 
abnormal  condition  of  the  urine  wdiich  contains  a  large  quantity  of  grape 
sugar.  The  true  cause  of  this  peculiar  disease  is  not  exactly  known, 
but  from  recent  observations  which  have  been  made  on  dogs  and  other 
animals  this  disease  seems  to  have  some  connection  with  diseases  of  the 
pancreas.  Minkowski  found  that  on  removal  of  the  entire  pancreatic 
gland,  sugar  appeared  in  the  urine  in  twenty-four  hours — the  amount  of 
sugar  was  10  per  cent. — and  death  in  a  few  weeks.  A  removal  of  a 
portion  of  the  pancreas  caused  slight  traces  of  sugar  in  a  short  time,  and 
if  the  greater  part  of  the  gland  is  extirpated,  leaving  only  a  very  small 
portion,  sugar  was  immediately  formed  in  the  urine  in  large  quantities, 
and  resulted  in  death  in  a  very  short  time.  Lepine  seems  to  think  the 
pancreas  has  the  property  of  taking  up  the  sugar  in  the  blood  and  when 
this  gland  is  destroyed  or  its  functions  become  impaired  in  any  way,  the 
sugar  in  the  blood  is  eliminated  by  the  kidneys.  This  is  further  con- 
firmed by  diabetic  dogs,  where  one  part  of  the  pancreas  is  invariably 
found  to  be  atrophied,  either  from  functional  loss  of  power  or  from  car- 
cinoma. Gebier  mentions  a  case  of  transitory  glycosuria,  where  a  bitch 
of  a  very  affectionate  disposition  and  accustomed  to  be  with  other 
dogs,  when  separated  from  the  other  dogs  and  confined  by  herself,  imme- 
diately had  sugar  appear  in  large  amount  in  her  urine. 

While  this  disease  is  comparatively  rare,  and  is  more  frequently 
seen  in  old  dogs,  occasionally  large  number  of  cases  may  be  seen  in 
certain  localities;  sex  seems  to  have  no  influence  on  the  disease,  as  it  is 
seen  equally  in  ])oth  sexes.  Eber  found  it  to  occur  most  frequently  in 
small  pet  dogs  that  have  little  or  no  exercise. 

Clinical  Symptoms  and  Course. — The  disease  develops  gradually;  the 
most   important  symptom  is   the  gradual   emaciation  notwithstanding 


DIABETES  MELLITUS  317 

the  fact  that  the  animal  may  have  an  enormous  appetite  and  be  fed 
with  the  most  nutritious  food.  The  animal  is  easily  fatigued,  is  made 
to  take  exercise  with  effort,  and  in  some  cases  moves  about  with  more 
or  less  difficulty.  The  animal  shows  great  thirst  and  drinks  enormous 
quantities  of  water,  at  the  same  time  passing  large  quantities  of  urine, 
which  in  most  cases  is  pale  and  colorless  and,  as  a  rule,  the  specific 
gravity  is  particularly  high  (1030  to  1060)  and  it  is  only  in  very  rare 
cases  that  the  specific  gravity  is  as  low  as  normal.  The  odor  of  the 
urine  is  very  characteristic;  it  resembles  that  of  fresh  fruit  (aceton). 
The  tests  already  described  can  be  used  to  demonstrate  the  presence  of 
sugar  in  the  urine,  the  fermentation  test  being  the  best  to  use.  Consult 
special  works.  The  quantity  of  sugar  present  in  the  urine  may  vary  in 
amount.  Eichhorn  states  that  in  one  case  he  found  11  per  cent,  and 
Haltenhof  found  12  per  cent,  in  another  case.  When  an  animal  is  fed 
on  a  pure  meat  diet  it  seems  to  lessen  the  amount  of  sugar  in  the  urine, 
although  there  are  certain  cases  where  even  this  diet  has  little  or  no 
effect  on  the  amount  of  sugar  present.  Albumin  is  sometimes  found  in 
the  urine  in  this  condition. 

In  many  cases  cataract  may  develop  (opacity  of  the  lens,  gray 
cataract),  appearing  simultaneously  in  both  eyes,  causing  total  blindness, 
in  some  cases  we  find  ulcerative  keratitis.  In  other  cases  the  hair  falls 
out;  vomiting,  persistent  diarrhoea,  falling  out  of  the  hair,  and  some  have 
noticed  an  inflammation  and  ulceration  of  the  skin  and  bleeding  of  the 
mucous  membrane  terminating  in  chronic  bronchial  catarrh  of  the 
lungs.  The  course  of  the  disease  is  gradual;  emaciation  and  debility 
increase  until  finally  the  animal  sinks  into  a  deep  coma,  accompanied,  as 
a  rule,  with  convulsions,  and  finally  death.  The  prognosis  in  all  cases 
should  be  unfavorable.  Post-mortem  generally  shows  atrophy  of  the 
pancreas  and  hypertrophy  and  fatty  degeneration  of  the  liver. 

Therapeutics. — The  treatment  of  diabetes  consists  of  feeding  the 
animal  on  food  which  does  not  contain  any  carbon,  or  as  little  as  possible. 
This  may  be  accomplished  to  a  certain  extent  by  a  meat-diet,  and  even 
this  diet  cannot  be  followed  up  for  any  great  length  of  time.  Give  eggs 
and  bran  bread,  vegetables  and  in  cases  where  it  cannot  be  avoided,  milk; 
but  wheat  bread,  sweets,  sugar  in  the  form  of  candy,  cakes,  rolls,  rice, 
peas,  lentils,  potatoes,  or  any  food  containing  starch  in  large  quantity, 
must  be  avoided.  A  pinch  of  carbonate  of  soda  must  be  given  three 
times  daily  in  the  drinking  water.  Other  preparations  such  as  arsenic, 
salines,  salicylate  of  soda,  carbonate  of  ammonia  or  acetate  of  ammonia 
are  useful.  Where  the  animal  is  in  a  state  of  coma,  use  subcutaneous 
injections  of  ether  or  camphor  in  combination  with  the  intravenous 
injections  of  normal  saline  solutions.  It  is  always  wise  not  to  change  the 
animal's  abode,  because  animals  sent  to  a  hospital,  affected  with  this 


318  CONSTITUTIONAL  DISEASES 

disease,  show  the  effects  of  worry  immediately,  by  the  increase  of  the 
amount  of  sugar,  if  sent  away  from  their  habitual  surroundings. 

Diabetes  Insipidus. 

This  condition  is  a  chronic  one  in  which  there  is  no  elevation  of 
temperature,  and  a  marked  increase  in  the  amount  of  clear  urine  secreted, 
which  is  of  a  low  specific  gravity  and  contains  no  sugar.  The  animal  is 
constantly  thirsty,  drinking  large  quantities  of  water.  This  disease  is 
less  frequently  seen  in  the  dog  than  diabetes  mellitus  and  must  not  be 
mistaken  for  ordinary  polyuria  which  is  seen  where  an  animal  drinks  very 
large  quantities  of  water,  or  as  a  result  of  the  administration  of  diuretics 
or  certain  poisons  or  spices,  or  from  atrophy  of  the  kidneys  after  the 
rapid  reabsorption  of  extensive  exudates  or  transudates.  It  is  also  seen 
in  a  more  or  less  pronounced  degree  in  convalescence  of  an  animal  from 
many  acute  diseases,  and  it  is  also  observed  in  certain  organic  diseases 
of  the  central  nervous  'system.  In  this  last  group  of  sympathetic  dia- 
betes belong  the  case  described  by  Holzmann;  this  dog  was  a  very  much 
emaciated  hound  three  years  old,  having  a  pale  mucous  membrane  and 
rectal  temperature  of  38.°  The  animal  drank  12.57  c.c.  of  water  daily, 
and  passed  about  12.79  c.c.  of  urine.  The  urine  was  yellowish,  had  a 
weak  acid  reaction,  its  specific  gravity  was  l.OOG,  and  contained  nothing 
abnormal.  On  post-mortem  nothing  of  any  great  consecjuence  was 
found,  except  a  myxoma  hyalinum,  which  appeared  in  the  shape  of  a 
yellowish,  transparent,  coagulated  mass  between  the  periosteum  and 
the  dura  mater,  entirely  surrounding  the  spine  with  the  exception  of  a 
small  portion  of  the  neck.  There  was  also  some  hyperemia  and  slight 
bleeding  in  the  gray  substance  of  the  lumbar  region.  Five  elongated 
osteoid  sarcoma  masses  were  found  pressing  on  the  dura  mater.  Holz- 
mann could  not  decide  which  of  these  two  conditions  was  the  true  cause 
of  the  disease.  If  we  eliminate  polyurias  due  to  some  organic  alteration 
of  the  cerebral  nervous  system,  as  a  result  of  chronic  interstitial  inflamma- 
tion of  the  kidneys,  then  polyuria  is  distinguished  from  diabetes  insipidus 
l)y  the  fact  that  the  former  is  transitory  in  its  character,  and  still  it  is 
only  by  close  observation,  lasting  for  some  time,  that  Ave  can  distinguish 
between  the  two  conditions;  polyuria  lasts  only  for  a  short  interval 
and  does  not  produce  any  great  tissue  changes,  whereas,  diabetes  insipi- 
dus gradually  progresses,  becoming  chronic,  and  is  accompanied  by 
great  emaciation.  The  urine  is  pale,  of  low  specific  gravity,  and  contrary 
to  chronic  nephritis,  contains  no  albumin.  In  all  the  cases  observed  by 
the  writer  which  he  took  at  first  for  genuine  diabetes  insipidus,  he 
found  where  he  could  follow  them  closely,  that  after  some  time  the 
polyuria  and   increased   thirst   gradually  disappeared.     Schindelka   de- 


OBESITY.     ADIPOSITAS  UXIVERSALIS  319 

scribed  one  case  where  the  animal  developed  cataract  and  abscesses  in 
different  parts  of  the  bod}',  and  other  complications  which  are  seen  in 
diabetes  mellitus. 

Therapeutics. — The  animal  should  be  put  on  a  strong  easily  digested 
diet  and  be  more  or  less  restricted  in  the  quantity  of  fluid  that  it  drinks; 
of  course  it  is  not  only  cruel  but  almost  impossible  to  restrict  the  animal 
as  to  the  quantity  of  water  that  it  drinks  if  it  is  thirsty,  but  the  food 
should  be  dry,  and  soup  or  other  liciuid  foods  should  not  be  given. 
Medicinally  the  following  drugs  are  recommended:  bromide  of  soda, 
preparations  of  iron,  opium,  boldo  root,  antipyrin,  ergot,  extract  of 
hydrastis,  hydrastin  and  other  vascular  alteratives.  Tannopin  may 
also  be  tried.  The  treatment  of  symptomatic  polyuria  consists  in 
attempting  to  remove  the  cause. 

Obesity.     Adipositas  Universalis. 

Etiology. — This  disease  is  due  to  the  absorption  of  large  quantities 
of  carbohydrates,  and  also  to  a  lack  of  proper  exercise,  and  in  some  cases 
as  a  consequence  of  improper  oxidizing  processes  in  the  body.  It  may 
also  be  hereditary  in  some  cases.  This  disease  is  especially  seen  in  lap- 
dogs  or  pet  animals,  and  is  also  noticed  in  bitches  after  ovariotomy, 
and  in  dogs  that  have  been  castrated. 

Clinical  Symptoms. — The  common  location  of  fatty  deposits  is  in 
the  panniculus  adiposus,  around  the  region  of  the  abdomen,  and  sur- 
rounding the  internal  organs — for  instance,  in  the  mediastinum,  the 
pericardium,  and  the  capsules  of  the  kidneys.  The  circumference  and 
weight  of  the  body  increase  very  much,  and  round  prominences  form  in 
different  parts  of  the  body,  especially  the  neck,  shoulders,  back,  and  hips. 
The  abdomen  is  round  and  distended.  The  animals  are  lazy,  dull, 
awkward,  and  tired  on  the  slightest  physical  exertion.  When  this  con- 
dition becomes  very  marked,  and  there  is  a  large  deposit  of  fat  in  different 
parts  of  the  body,  especially  when  it  has  accumulated  in  the  thorax  and 
neighborhood  of  the  heart,  we  have  a  lessened  heart-action  and  more  or 
less  difficulty  in  respiration,  sometimes  from  the  pressure  of  quantities 
of  fat  on  certain  blood-vessels,  decreasing  their  size  and  thus  requiring 
gi-eater  effort  of  the  heart 's  action,  until  finally  the  heart  becomes  over- 
taxed, and  we  have  symptoms  of  heart-failure,  bronchitis,  chronic 
catarrh  of  the  stomach,  and  oedema. 

Therapeutic  Treatment. — The  most  important  factor  in  the  treatment 
of  obesity  is  abundant  and  regular  exercise  in  the  open  air  and  restricted 
feeding^  the  food  must  be  albuminous,  and  fat  and  carbo-hydrates 
avoided.  Sugar  in  any  form,  candy,  sweets,  etc.,  must  be  prohibited. 
Meals  must  be  given  at  regular  intervals,  in  a  young  dog  three  times 


320  CONSTITUTIONAL  DISEASES 

daily,  a  dog  over  a  year,  two  meals  daily;  a  small  meal  in  the  morning 
and  the  good  meal  at  night;  dogs  that  have  very  little  exercise,  one  meal 
daily  is  sufficient,  and  as  a  rule  they  seem  to  do  very  nicely  on  it.  Slight 
laxatives,  especially  the  salines,  such  as  Apenta,  Hunyadi,  or  Veronica 
waters,  in  teaspoonful  doses  once  daily,  and  a  pinch  of  phosphate  of 
soda  in  the  morning.  There  seems  to  be  some  value  in  the  administration 
of  the  preparations  of  the  thyroid  glands  (thyroid,  thyroidin,  or  iodothyrin 
tablets),  these  tablets  contain  the  equivalent  of  0.3  of  fresh  thyroid 
gland  and  are  to  be  given  according  to  the  size  of  the  animal,  from  1  to 
3  tablets  daily.  Seven  clogs  were  treated  with  thyroidinum  depuratum 
in  doses  of  0.15  daily,  and  in  from  one  to  four  weeks  the  animals  were 
reduced  in  amounts  varying  from  350  to  3460  grams.  But  these  prepara- 
rations  must  be  used  with  great  care,  beginning  with  a  very  small  dose 
and  gradually  increasing  it.  Iodide  of  potassium,  boracic  acid  and  borax 
are  not  to  be  recommended  as  they  are  apt  to  cause  disorder  of  the 
digestion. 

Uraemia. 

As  a  consequence  of  this  disease  and  impaired  activity  of  the  kid- 
neys, certain  substances,  that  should  be  thrown  out  in  the  urine,  remain 
in  the  blood;  also  the  watery  excretions  of  the  body,  acting  as  a  poison, 
produce  a  condition  known  as  ''ursemia."  The  exact  nature  of  the 
materials  that  cause  this  disturbance  is  not  definitely  knowai,  but  in  all 
probability  it  is  not  due  to  one,  but  to  several  substances,  such  as  albu- 
minous decompositions  and  certain  end-products.  Ursemia  is  usually 
Been  as  a  result  of  acute  inflammation  of  the  kidney,  hydronephrosis, 
obstruction  of  the  neck  of  the  bladder,  or  urethra,  by  calculi;  from 
tumors  of  the  prostate,  paralysis  of  the  detrusor,  and  rupture  of  the 
bladder.  The  disease  may  be  acute  or  chronic,  and  one  form  may  merge 
into  the  other.  The  acute  form  is  seen  in  acute  inflammation  of  the 
kidney  and  retention  of  urine  in  the  bladder,  in  this  case  there  is  j^er- 
sistent  vomiting,  convulsive  twitching  of  the  muscles,  convulsions,  coma 
and  subnormal  temperature.  The  chronic  forms  may  appear  following 
chronic  nephritis,  and  from  partial  retention  of  the  urine,  it  is  seen  par- 
ticularly in  stone  in  the  urethra,  when  the  passage  is  not  completely 
obstructed,  but  only  allows  a  very  small  quantity  of  urine  to  escape, 
when  this  is  present  there  is  depression,  loss  of  appetite,  irregular  vomit- 
ing, occasional  convulsions,  diarrhcra.  Certain  experiments  have  been 
made  on  the  dog  to  artificially  produce  these  ura}mic  symptoms — 
for  instance,  by  removing  both  kidneys  or  ligitating  the  ureters.  Voit 
observed  that  when  healthy  animals  were  fed  on  food  containing  uric 
acid,  and  at  the  same  time  deprived  of  water,  these  conditions  pro- 


SCURVY  321 

duced  the  disease.  Grehant  and  Qiiinwuaud  produced  death  in  dogs 
when  urea  was  injectetl  into  them  subcutaneously  to  the  amount 
of  1  per  cent,  of  the  whole  weight  of  the  body.  This  produces  convul- 
sions, apparently  from  suppression  of  respiration.  Feltz  and  Ritter 
produced  uraemic  symptoms  in  the  dog  with  injections  of  salts  of  ammo- 
nium. It  is  of  practical  interest  to  know  that  uraemia  may  also  occur  in 
acute  nephritis,  in  cases  of  enlargement  of  the  prostate  and  obstruction 
of  the  passage  of  urine,  or  from  uratic  stones  filling  up  the  urethra  or  the 
neck  of  the  bladder. 

The  clinical  symptoms  have  been  described  by  Roll  and  others  as 
high  temperature  alternating  with  chills,  constant  vomiting,  convulsions, 
paralysis,  coma,  decrease  in  the  temperature,  and  death  within  a  few 
days.  Roll  also  states  that  dogs  which  have  suffered  with  hypertrophy 
of  the  prostate  showed  the  same  symptoms  of  this  disease,  but  these  were 
produced  gradually  and  the  symptoms  were  not  so  acute.  In  such  cases 
we  find  dulness,  disturbance  of  the  intestinal  canal,  and  convulsions. 

Treatment. — The  treatment  of  uraemia  is  based  on  an  endeavor  to 
remove  or  lessen  the  original  cause  (nephritis,  etc.).  If  there  is  a  calculus 
present,  it  must  be  removed  as  soon  as  possible;  and  to  eliminate  the 
poisonous  materials  from  the  blood,  use  mild  saline  laxatives  and  treat 
symptoms. 

Scurvy. 

It  is  doubtful  if  true  scurvy  occurs  in  the  dog — that  is  to  say,  a 
hemorrhagic  diathesis  marked  by  a  spontaneous  bleeding  of  the  mucous 
membranes  of  the  mouth,  and  also  from  the  muscles,  joints,  etc. 
This  may  occur  as  an  epidemic;  sporadic  cases  are  extremely  rare. 
It  is  a  question,  however,  whether  true  scurvy  does  occur  and  whether 
it  is  not  an  attack  of  ulcerative  stomatitis,  which  in  the  older  text 
books  was  described  as  pesu do-scurvy,  or  it  is  possible  that  it  is  dis- 
temper, or  septic  or  some  condition  due  to  the  toxins  in  the  blood.  It 
may  result  from  the  feeding  of  tainted  or  decayed  meat  or  particularly 
in  packs  of  hounds  where  the  dogs  are  fed,  entirely  on  meat,  and 
never  any  vegetables.  Seltzner  described  one  case  that  in  some  re- 
spects resembled  Basedow's  disease;  a  haemorrhagic  diathesis  and  in 
other  respects  it  was  similar  to  rickets. 

There  were  numerous  haemorrhagic  centres  in  the  skin  and  cellular 
tissues.  The  buccal  mucous  membrane  was  somewhat  swollen  and 
filled  with  haemorrhagic  spots,  or  even  necrotic.  The  gums  were  also 
in  the  same  condition.  There  was  loosening  and  falling  out  of  the  teeth, 
horrible  odor  from  the  mouth  and  salivation,  bleeding  from  the  mouth, 
bloody  urine,  and  sometimes  blood  was  vomited,  in  one  case  there  was 

21 


322  CONSTITUTIONAL  DISEASES 

blood  in  the  anterior  chamber  of  the  eye,  and  an  extravasation  of  the 
epiploon.  Animals  generally  die  of  exhaustion,  and  post-mortem  may 
show  extensive  hemorrhage  of  the  intestinal  tract,  pneumonia  and 
pyaemia. 

Treatment. — Local  treatment  of  the  mouth  with  astringents,  lis- 
terine,  permanganate  of  potash,  regulation  of  diet.  Where  animals  like 
packs  of  hounds  have  been  fed  on  nothing  but  meat,  a  combination  with 
vegetables  seems  to  be  advantageous;  the  regular  diet  of  cooked  meat 
should  have  greens  such  as  spinach  or  the  ordinary  dandelion,  root  and 
leaves  cooked  with  it.  General  tonics,  such  as  gentian  or  nux  vomica, 
and  when  there  is  general  hemorrhage  the  internal  administration  of 
hemostatics  is  useful. 

Priessnitz's  Bandage  or  Compress. 

This  compress  is  mentioned  a  number  of  times  in  the  work,  and  as 
it  has  special  advantages  in  the  treatment  of  dogs,  the  translator  will 
attempt  to  describe  it,  as  the  author  has  not  done  so,  probably  due  to  the 
fact  that  it  is  so  very  well  known  in  German  therapeutics  that  it  needed 
no  explanation,  but  to  English-speaking  veterinarians  this  is  the  reverse. 

The  object  of  the  compress  or  bandage  is  to  keep  up  a  continual 
heat,  either  dry  or  moist,  to  certain  parts  of  the  animal's  body.  We 
first  apply  against  the  part  afTected  a  piece  of  absorbent  cotton,  thick 
W'ool,  or  dry  felt;  or  if  moist  heat  is  recfuired,  it  is  soaked  in  warm  water 
or  a  medicated  solution  and  wrung  out  to  remove  the  excess  of  fluid; 
this  is  then  held  in  position  by  a  covering  of  some  light  material — a  wide 
bandage  of  cheese-cloth  is  the  best — and  next  a  layer  of  oiled  silk  or 
rubber  cloth  (the  object  of  this  is  to  retain  the  heat  and  in  case  of  a  wet 
compress,  the  moisture),  and  finally  over  this  is  placed  a  compress  or 
bandage  of  flannel.  This  last  is  to  prevent  loss  of  heat  by  radiation. 
Sometimes  the  inner  layer  of  cheese-cloth  is  omitted,  or  else  it  is  put  on 
the  outside  of  all. 

The  above  procedure  may  seem  to  the  hurried  practitioner  a  rather 
long  and  unnecessary  method,  but  after  one  has  tried  it  and  found  the 
great  advantages  it  has  in  the  retention  of  heat,  especially  in  diseases  of 
the  lungs,  in  hastening  the  maturing  of  an  abscess,  or  in  the  lessening  of 
a  tumefaction  by  the  constant  and  direct  application  of  heat  and  moisture, 
he  will  realize  its  benefits. 


DISEASES  OF  THE  ORGANS  OF  LOCOMOTION. 

DISEASES  OF  THE  BONES. 

Rachitis. 

(Rickets.) 

Etiology. — The  different  theories  -which  have  been  advanced  con- 
cerning the  origin  of  rachitis  do  not  seem  to  answer  in  all  cases.  These 
theories  are  as  follows;  it  is  due  to  a  deficiency  of  lime-salts  as  a  conse- 
quence of  disturbances  of  digestion;  to  excessive  formation  of  lactic  acid, 
in  the  blood  and  to  salts  of  potassium  in  the  milk  or  to  a  lack  of  hydro- 
chloric acid  in  the  gastric  juice,  which  would  dissolve  the  lime-salts;  an 
alteration  of  the  general  nutritive  condition  on  account  of  abnormal 
influences  in  young  animals;  inflammatory  hypersemia  and  an  increase  in 
the  number  and  size  of  blood-vessels  in  the  osteogenetic  tissues,  so  that 
the  lime-salts  continue  to  circulate  in  the  blood  instead  of  being  deposited 
in  the  bones.  Xone  of  these  theories  stands  the  test  of  close  observation, 
we  therefore  do  not  know  positively  anything  relating  to  the  character 
and  origin  of  rachitis.  It  is,  perhaps,  better  to  admit  that  it  is  a  specific 
etiological  change  (which  has  not  as  yet  become  positively  known).  We 
know  positively,  however,  that  rickets  can  be  developed  in  the  dog  by 
deficient,  improper  food,  by  want  of  meat,  and  especially  bones,  as  it  has 
been  demonstrated  that  animals  with  this  disease  if  given  these  articles 
of  diet  seem  to  improve  immediately.  Insufficient  food  to  the  bitch 
during  gestation,  or  trying  to  raise  too  large  a  litter,  or  early  weaning, 
improper  food,  keeping  animals  in  cellars  or  in  dark,  damp  places  are  all 
factors  that  tend  to  cause  rickets.  A  proper  amount  of  exercise  is 
especially  important  for  puppies  kept  in  a  small  place. 

Rickets  generally  appears  in  young  animals  in  the  first  few  months 
of  their  life.  It  is  often  hereditary,  as  is  frequently  seen  as  a  result  of 
very  close  breeding  and  also  in  breeds  where  color  or  conformation  is  the 
chief  object,  such  as  bull  terriers,  collies,  or  great  danes,  and  where  a 
breed  is  not  old  enough  to  be  established,  as  Boston  terriers.  The 
symptoms  appear  relatively  in  proportion  to  their  growth.  If  the  puppy 
grows  quickly,  rickets  appears  quickly;  if  it  grows  slowly,  the  disease 
comes  on  gradually. 

Pathological  Anatomy. — Rickets  consists  of  a  peculiar  disturbance 

323 


324 


DISEASES  OF  THE  ORGANS  OF  LOCOMOTION 


of  the  bones  of  the  whole  system,  which  can  easily  be  distinguished  on 
looking  at  the  animal.  It  seems  to  be  due  to  a  deficiency  of  lime-salts 
in  the  bones,  making  them  soft  and  flexil;)le.  At  the  same  time  the 
nutritive  process  in  the  periosteum  seems  to  be  changed.  The  bones  are 
light  and  soft  enough  to  cut  with  a  knife,  and  the  epiphyses  of  the  long 
bones  are  very  much  thickened;  the  marrow  and  periosteum  are  reddened. 

When  the  periosteum  is  forcibly  removed  from 
the  bones  of  the  animal  in  this  condition,  cer- 
tain portions  of  the  bony  tissue  come  away 
and  remain  attached  to  the  membrane.  This 
is  especially  noticeable  between  the  epiphyses 
of  the  vertebrse.  The  inner  layer  of  the  peri- 
osteum is  thickened  and  the  diseased  tissue 
seems  to  have  undergone  a  spongy  degener- 
ation. Inside  of  the  bone  we  find  it  soft  and 
cavernous.  In  the  normal  dog  the  bones  of  the 
skull  are  joined  evenly,  but  in  the  rachitic  dog 
interosseous  spaces  (fontanels)  have  been 
found. 

Clinical  Symptoms  and  Course. — Omitting 
the  animals  that  are  born  with  rickets,  the  first 
appearance  of  rickets  is  gradual,  and  generally 
the  veterinarian  is  not  consulted  in  the  early 
stages,  but  only  when  the  skeleton  shows 
marked  alterations  of  form,  especially  the 
bones  of  the  extremities  and  back.  The  ani- 
mals are  dull,  walk  very  carefully  and  with 
more  or  less  effort,  have  no  desire  to  run  about, 
but  lie  down  as  long  as  they  can.  We  find  peri- 
osteal alterations  in  the  frontal  bones  and 
bones  of  the  temple,  so  that  the  head  shows 
a  peculiar  marked  alteration  in  conformation. 
Schutz  has  found  that  in  rachitic  animals  the 
bones  of  the  skull  are  extremely  thin  and  the 
sutures  separated.  In  the  thorax  there  is  a 
weakening  of  the  walls  of  the  chest,  and  the 
animals  present  that  one-sided  or  "  chicken- 
chest"  condition.  There  is  a  peculiar  knot-like  swelling  of  the  ribs  both 
at  their  upper  extremities  where  they  unite  with  the  vertebrae,  and  in  their 
inferior  extremities  where  they  unite  with  the  sternum  and  false  ribs. 

In  this  latter  condition  there  forms  a  series  of  small,  round  nodules 
known  as  ''rachitic  rosary."  In  acute  forms  of  this  disease  the  spinal 
cord   is   twisted   or   bent   in   different    directions   (kyphosis,  lordosis  or 


Fig.  102. — Radius  and  ulna  of  a 
dog  afifected  with  rickets. 


FRACTURES  OF  THE  BONES  325 

skoliosis).  The  most  striking  alterations  are  ol)served  in  the  extremities. 
The  long  bones  are  thickened  at  both  ends  and  bent  on  account  of  the 
softness  of  the  bone  and  pressure  of  the  weight  of  the  body,  when  stand- 
ing (Fig..  102).  The  upper  portion  of  the  front  legs  bends  inward,  rarely- 
outward,  and  the  animals  have  a  peculiar,  unsteady,  awkward  gait. 
The}'  stand  on  the  hind  legs  with  the  leg  twisted  under  them,  and  in 
aggravated  cases,  the  bones  are  bent  in  a  circle,  the  bend  of  the  astragalus 
coming  down  on  the  ground  (Plate,  Rachitis).  As  a  consecpience  of  the 
altered  position  of  the  bones,  the  ligaments  Ijecome  distended  and  stretched, 
causing  an  inflammation  of  the  joints  and  consequently  more  or  less 
enlargement  of  them.  At  the  same  time  we  ol^serve  emaciation,  loss  of  ap- 
petite, and  in  some  cases,  catarrh  of  the  stomach  and  air-passages,  changes 
in  the  shape  of  the  teeth,  which  are  aljnormally  small  and  frequently 
devoid  of  enamel,  or  placed  irregularly  in  the  gums.  The  disease,  as  a 
rule,  is  chronic  and  the  prognosis  unfavorable.  If  the  disease  is  taken 
early,  it  may  be  checked  to  a  certain  degree  by  means  of  proper  feeding; 
but  when  the  deformity  is  once  formed,  it  is  only  in  extremely  rare  cases 
that  it  does  not  show  as  the  animal  grows  to  an  adult  age  either  in  the 
form  of  a  peculiar  bending  or  bow-legged  appearance  of  the  front  legs, 
or  a  twisting,  or  show  halt-shape  in  the  hind-legs. 

Therapeutic  Treatment. — The  treatment  of  rachitis  consists  of 
improving  all  the  nutritive  conditions  and  encouraging  digestion  as 
much  as  possible.  Give  the  animal  plenty  of  meat  and  bones,  adding 
to  them  certain  amount  of  phosphate  of  calcium,  egg-shells,  and  lime- 
water  in  the  drinking  water.  Phosphorus,  while  medicated,  generally 
causes  irritation  of  the  intestines.  Improve  the  digestion  as  much  as 
possible  by  tonics,  nux  vomica,  gentian,  etc.;  keep  the  animal  in  a  clean, 
dry  place  and  see  that  there  is  good  ventilation.  If  there  is  diarrhoea, 
give  bismuth  subnitrate.  To  avoid  bending  of  the  articulations,  the 
animal  must  be  prevented  from  taking  unusual  exercise,  running,  jump- 
ing, etc.  Splints  are  sometimes  used  to  correct  the  curving  of  the  long 
bones. 

I^.       Ferri  lactis  5.0 

Calcium  phos., 

Calcium  carbonate, 

Saccharum  lactis,  aa  20.0 

F.  M.  pulv. 

Sig. — One  small  teaspoonful  in  the  food  twice  daily. 

Fractures  of  the  Bones. 

By  a  "fracture  of  the  bone''  we  mean  a  breaking  or  disunion  of  a 
bone  or  a  bony  cartilage;  fracture  is  quite  common  in  the  dog,  particu- 


326  DISEASES  OF  THE  ORGANS  OF  LOCOMOTION 

larly  the  bones  of  the  extremities,  femur,  radius,  tilna  and  filuila,  uhia 
and  humerus  and  metacarpus  and  pelvis  being  the  commonest,  less 
frequently  seen  are  the  metatarsus;  the  sternum,  ribs,  cranium,  vertebrae, 
and  scapula  are  very  rarelj'  seen. 

Etiology  and  Prognosis. — IMost  fractures  are  caused  by  external 
forces,  and  the  bone  fractured  is  at  the  region  where  the  force  or  shock 
has  expended  most  of  its  force — for  instance,  from  blows  or  being  run 
over,  hit  with  a  stone,  or  in  some  instances  a  fracture  may  be  some 
distance  from  the  region  where  the  greatest  amount  of  force  has  been 
made,  such  as  falling  for  some  distance,  or  concussions.  We  also  see 
fractures  of  small  projections  of  bones  caused  Ijy  great  muscular  exertion. 
Very  old  and  very  young  dogs  have  a  predisposition  to  fractures  and 
rickets,  or  a  tendency  that  way  may  also  produce  fractures  from  a 
weakened  or  softened  condition  of  the  bone. 

We  separate  fractures  under  different  names  according  to  their 
position,  severity,  and  the  complications  accompanying  them. 

In  the  first  class  belong  infractions,  splits  or  cracks,  impressions  or 
depressions. 

In  the  second  class  belong  obliciue,  transverse,  longitudinal,  and 
fissure  fractures. 

In  pups  the  epiphysis  and  diaphysis  are  sometimes  fractured  through 
the  symphysis,  due  to  traumatic  influences.  This  fracture,  which  is 
rather  common,  especially  in  the  humerus  and  radius,  is  always  confined 
to  the  immediate  neighborhood  of  the  symphysis.  The  general  course 
of  these  fractures  is  the  same  as  ordinary  fractures,  and  no  special  men- 
tion is  necessary  regarding  fractures  of  the  soft  bone,  which  in  the  young 
animal  has  not  yet  hardened. 

The  condition  of  the  soft  tissues  in  the  neighborhood  of  the  fractures 
and  the  amount  of  injury  that  they  have  had  are  of  great  importance 
in  the  prognosis.  All  fractures  in  which  the  soft  tissues  are  not  very 
much  injured,  and  where  the  skin  has  not  been  torn,  heal  very  much  more 
quickly  than  those  where  there  is  an  open  wound  extending  into  the 
fractured  end  of  the  lione.  The  first  are  termed  simple  fractures,  and 
the  latter,  compound  fractures.  Where  the  fracture  has  involved  a  joint, 
it  is  called  an  intra-articular  fracture.  The  compound  and  intra-articular 
fractures  are  very  slow  and  difficult  to  treat,  and  present  such  symptoms 
as  synovitis,  either  with  or  without  serous  or  purulent  inflammations. 
In  such  fractures,  even  when  we  have  union  of  the  broken  ends  of  the 
bone  we  may  have  as  an  after  result  a  stiff  joint  or  ankylosis  from  com- 
plications in  the  joint. 

Clinical  Symptoms. — The  symptoms  of  fractures  are  generally 
indicated  by  partial  or  complete  loss  of  the  use  of  the  whole  or  part  of  a 
limb.     There  is  pain  on  pressure,  deformity  in  the  symmetry  of  the  broken 


FRACTURES  OF  THE  BONES 


327 


bones  of  that  part  of  the  body,  and  on  moving  the  fractured  ends 
there  is  a  rubbing  sound  (crepitation)  similar  to  rubljing  two  hard, 
rough  surfaces  against  each  other.  The  amount  of  loss  of  power  in  a 
broken  bone  depends  to  a  great  extent  on  the  amount  and  s(n-crity  of 
the  fracture.  This  is  ver}^  marked  in  fractures  of  the  extremities;  great 
pain  on  pressure,  especially  on  the  line  of  the  fractured  bones.  This 
may  also  be  of  especial  diagnostic  importance  in  case  of  cracks  or  fissures 
of  the  bone.  In  such  a  case,  while  the  symptoms  are  all  present,  the 
ends  of  the  bones  are  not  displaced.  This  is  generally  seen  in  the  longi- 
tudinal form  and  in  very  young  animals  where  the  bone  pi^'ots  on  the 


Fig.  Wo. — .Skiagraph  of  fracture  of  the  humerus. 

fractured  epiphysis.  Crepitation  and  an  abnormal  movement  are 
easily  recognized  by  taking  hold  of  the  part  above  and  below  the  frac- 
ture and  moving  it  in  different  directions.  Both  of  these  symptoms 
are  absent  in  incomplete  fractures  and  in  such  fractures  where  the  bones 
will  close  together  with  very  little  displacement.  This  is  especially  seen 
in  longitudinal  fractures  of  the  short  compact  bones.  We  occasionally 
find  a  mild,  rubbing  loruit  or  sound  produced  by  dry  blood-extravasations 
or  fibrinous  coagulations  between  the  surfaces  of  joints.  In  cases  of 
fracture  where  the  periosteum  has  not  been  torn,  we  will  have  a  certain 
amount  of  swelling  in  the  fractured  region,  pain  on  pressure,  loss  of 
appetite,  and  a  certain  amount  of  fever.  This  last  symptom,  however, 
is  rarely  noticed.     When  there  is  any  uncertainty  about  the  cUagnosis 


328 


DISEASES  OF  THE  ORGANS  OF  LOCOMOTION 


it  is  well  to  have  a  skiagraph  (X-ray)  made  of  the  affected  part  (Fig.  103). 
Where  there  is  an  external  wound  which  becomes  rapidly  closed 
by  the  blood  and  the  purulent  agents  cannot  penetrate  between  the 
fractured  ends  of  the  bone,  we  have  a  form  of  fracture  that  is  not  so 
difficult  to  treat;  but  if  any  septic  materials  should  have  penetrated 
into  the  wound  and  found  their  way  between  the  ends  of  the  bones, 
the  condition  is  generally  indicated  in  the  following  manner:  There  is  a 
marked  inflammatory  sweUing  in  the  neighborhood  of  the  wound.  At 
first  the  discharge  from  the  wound  is  blood-colored,  then  rapidly  becomes 
pus-like,  and  finally  purulent  in  character.  If  the  discharge  becomes 
ol)structed  in  any  way,  we  quickly  notice  a  purulent,  oedematous  swelling 
all  around  the  part,  which  is  always  a  very  grave  symptom.     If  the 

course  is  favorable,  the  injured  part  becomes 
rapidly  filled  with  red,  granulating  tissue, 
which  finally  dries,  becomes  hard,  and  forms 
a  scab.  By  means  of  strict  antiseptic  treat- 
ment this  is  possible,  and  we  can  reduce 
the  danger  and  time  of  an  open  fracture  by 
strictly  following  the  usual  antiseptic  forms 
of  treatment.  In  the  dog,  however,  this  is 
always  rather  difficult  to  accomplish,  as  the 
animals  are  hard  to  confine,  moving  about 
constantly  and  pullirtg  or  tearing  the  band- 
ages. 

The  Phenomena  of  Union  in  Fractures. 
— The  healing  and  union  of  the  fractured 
ends  of  a  bone  are  very  similar  to  those  of 
wounds,  either  by  first  intention  (primum 
intentionem)  or  by  second  intention  (secun- 
dum intentionem) .  In  simple  fractures  we 
generally  get  union  by  first  intention,  and  in  compound  fractures,  unless 
the  union  be  extremely  small,  we  get  union  by  second  intention  (Fig. 
104).  In  both  cases  the  union  is  accomplished  by  means  of  a  callus 
growing  around  the  ends  of  the  bone — that  is  to  say,  a  soft  cellular 
tissue  which  forms  an  envelope  surrounding  the  bone  and  gradually 
becoming  hard  through  the  ossific  action  of  the  periosteum  and  the 
marrow  of  the  bones.  The  ring-shaped  or  external  callus  surrounds  the 
fractured  parts.  This  cellular  tissue  is  formed  of  osteoblasts.  The 
inner  callus  is  formed  by  the  marrow,  forming  a  peculiar  plug-shaped 
body  and  filling  up  the  open  ends.  The  periosteum  is  the  true  factor 
in  making  union  between  l)roken  ends  of  bones.  This  is  especially  noticed 
in  fractures  where  the  periosteum  is  exposed,  and  where  that  envelope 
is  torn  or  injured,  union  is  almost   twice  as  long  as  where   the   peri- 


FiG.  104. — Diagram  of  union  of  frac- 
ture in  the  tibia  of  the  dog:  a,  outer 
callus;  b,  periosteum;  c,  inner  callus:  d, 
inflammatory  deposit. 


FRACTURES  OF  THE  BONES  329 

ostcum  is  prcsorvetl.  Tho  extravasation  of  blood  found  in  the  early 
stages  of  a  fracture  which  hes  in  the  surrounding  parts  does  not  in  any 
way  assist  in  the  actual  union,  but  helps  to  a  certain  extent  in  holding 
the  bones  together  until  the  callus  is  formed.  The  callus,  in  the  begin- 
ning, is  a  spongy  mass,  especially  in  bones  containing  a  large  quantity  of 
marrow.  This  gradually  changes  into  a  bony  cicatrix  or  callosity.  This 
becomes  thinner  and  denser,  lessening  in  diameter,  and  finally  becomes 
smooth  on  its  surface,  forming  what  is  known  as  ''final  callus."  Reab- 
sorption  commences  at  the  same  time  until  the  body  masses,  which 
are  useless  after  the  bone  is  united,  finall}'  disappear,  l)ut  there  is  always 
a  certain  amount  of  enlargement  around  the  fractured  ends  of  a  bone 
at  the  point  of  union.     Cracks  and  fissures  undergo  the  same  process. 

Period  of  the  Process  of  Union  in  Fractured  Bones. — The  time  required 
to  obtain  complete  union  of  a  fracture — that  is  to  say,  until  the  animal 
can  use  the  part  without  any  pain  or  difficulty — depends  largely  on  the 
size  and  position  of  the  bone,  the  age  of  the  animal,  and  the  amount  of 
use  the  patient  makes  of  it.  According  to  the  observations  of  the 
writer  and  others,  in  fractures  in  which  the  periosteum  is  not  torn,  or 
simple  fractures  of  the  large  bones  containing  marrow,  the  time  is  from 
eighteen  to  twenty-four  days  in  adult  healthy  animals.  Fractures  of 
the  ribs  unite  in  from  ten  to  fifteen  days;  in  metacarpal  and  metatarsal 
bones,  ten  to  eighteen  days.  In  young  animals  the  process  is  a  few  days 
shorter;  in  very  old  animals  it  is  much  longer.  After  the  union  of  the 
fracture,  as  a  rule,  the  affected  leg  is  not  used  with  as  great  freedom  as 
it  was  before.  This  is  especially  noticeable  in  young  animals  that  are 
growing.  Very  often  there  is  a  subsequent  atrophy  and  impaired 
development  of  the  muscles  of  that  part.  While  this  may  be  due  to  a 
certain  extent  to  the  inactivity  of  the  muscles,  when  tied  up  in  the  splint, 
and  also  to  pressure  of  the  dressing,  it  is  often  noticed  after  the  dressing 
is  removed,  and  sometimes  for  weeks  afterward,  the  animal  walks  stiff 
or  is  even  lame;  massage  of  the  affected  leg  is  useful. 

Therapeutic  Treatment. — In  simple  fractures  the  treatment  con- 
sists of  returning  the  broken  ends  of  the  bone  to  their  proper  anatomical 
position,  and  holding  them  securely  in  place. 

The  bringing  together  of  the  fractured  ends  of  the  bones  must  be 
done  as  soon  as  possible,  and  it  is  accomplished  by  pulling  or  extending 
them  in  a  longitudinal  direction  until  the  fractured  ends  fit  together.  In 
some  instances  where  the  tissue  is  loose  they  have  to  be  pressed  back  in  • 
their  normal  position.  The  animal  should  be  held  by  an  assistant  while 
the  operator  manipulates  the  ends  into  position.  In  cases  where  there 
is  extreme  pain  and  in  order  to  keep  the  animal  from  struggling,  it  is 
advisable  to  etherize,  or  better,  give  the  animal  a  sulx-utaneous  injection 
of  morphine.     In  such  cases  as  fractures  of  the  metacarpal  bones,  bones 


330 


DISEASES  OF  THE  ORGANS  OF  LOCOMOTION 


of  the  face,  etc.,  reduction  can  be  made  without  an  assistant.  ^Vhen 
the  bones  have  been  placed  in  position  as  neai-  as  possil^le  to  their  normal 
shape,  we  must  then  apply  a  dressing  which  will  keep  the  fractured  ends 
in  their  position  until  they  have  united. 

The  best  dressing  for  fractures  in  dogs  are  those  which  dry  rapidly, 
such  as  plaster  or  silicate  of  sodium  solutions.  In  some  cases  it  becomes 
necessary  to  apply  a  temporary  splint  apparatus  for  a  few  days.  This 
temporary  splint  apparatus  must  be  used  where  there  is  great  swelling,  or 
where  the  condition  of  the  wound  or  part  w^ould  lead  you  to  expect  much 
swelling.     The  writer  finds  the  best  thing  for  fracture  dressings  is   a 


Fig.   105. — Plaster  splint  on  fracture  with  support  around  body. 


broad  pasteboard  splint.  This  should  be  dipped  in  water  and  kneaded 
by  the  hand  until  flexible.  There  are  various  other  materials  for  making 
splints — gutta-percha,  wire  gauze,  spongio-piline,  felt,  sheet  tin  or  zinc, 
wood,  etc.  In  some  cases  where  there  is  an  open  wound  wire  gauze  may 
be  used,  fastened  above  and  below  the  fractured  ends  of  the  bone, 
leaving  the  wounds  exposed.  This  gives  it  sufficient  support,  and 
admits  of  proper  antiseptic  methods  being  followed.  A  plaster-of-Paris 
or  silicate  of  sodium  dressing  may  be  applied  immediately  after  the  frac- 


FRACTURES  OF   THE  BOXES  331 

tiire,  provided  thci'c  arc  no  wounds.     Where  there  are  wounds  or  swellings 
we  must  wait  until  the  swelling  is  absorbed. 

\\'c  apply  a  permanent  dressing,  or  a  temporary  dressing  may  be 
put  on  in  the  following  manner:  Cover  it  thoroughly  with  cotton  wadding 
and  apply  the  ordinary  bandage,  taking  care  not  to  make  it  too  tight. 
In  plaster-of-Paris  dressings,  the  ordinary  gauze,  crinoline,  or  cheese- 
cloth may  be  used,  and  the  plaster,  in  powder  form,  rubbed  into  the 
bandage  while  it  is  being  rolled.  Then  rub  a  small  amount  of  oil  (swdet) 
into  the  skin  about  the  point  of  fracture  to  prevent  the  bandage 
sticking.  At  the  same  time  place  the  plaster  bandage  in  water  for  a 
few  minutes  and  then  wrap  it  carefully  around  the  splint,  following  the 
methods  adopted  in  ordinary  bandage  rolling,  being  careful  not  to  place 
it  too  tightly.  Smoothe  the  water  out  of  the  part,  making  the  bandage 
as  level  as  possible.  In  some  cases  where  you  want  a  very  stiff  ban- 
dage, it  is  advisable  to  put  a  certain  amount  of  plaster  between  the 
folds  of  the  bandage  and  finally  give  a  good  coating  over  the 
entire  bandage.  After  the  dressing  has  been  applied,  the  animal 
must  be  kept  perfectly  quiet  for  at  least  ten  to  twenty  minutes 
to  allow  the  dressing  to  become  hard.  A  plaster  dressing  will  dry 
and  harden  a  little  more  quickly  by  the  addition  of  a  small  quantity  of 
alum  or  common  salt;  a  little  glycerine  added  to  plaster  makes  it  much 
harder.  A  pair  of  curved  scissors  are  the  most  practical  for  the  removal 
of  the  dressing.  Tripolith  dressing  (a  mixture  of  plaster-of-Paris  and 
soot)  can  be  applied  in  the  same  manner  as  the  plaster.  Its  composition 
is  said  to  be  much  lighter  and  it  dries  much  more  rapidly.  Silicate  of 
sodium  dressing  has  the  advantage  of  lightness,  durability,  and  of  being 
removed  easily,  but  it  has  one  disadvantage,  and  that  is  it  dries  slowly, 
sometimes  taking  a  couple  of  hours.  The  writer  likes  this  form  of 
dressing  best,  and  to  overcome  the  drawback  of  slow  hardening  has 
placed  thin  layers  of  wire  gauze  between  the  dressings.  Flannel  may  be 
used  as  an  under  layer.  Another  dressing  is  a  mixture  of  benzoate  of 
sodium  and  silicate  of  sodium.  In  fractures  situated  in  the  upper 
sections  of  the  leg  where  the  extremity  is  cone  shaped,  it  is  necessary  to 
build  up  the  bandage  in  numerous  layers  to  give  it  body  so  as  to  hold  to 
the  position  of  the  leg,  in  other  cases  the  bandage  should  be  carried  around 
the  bod}^  so  as  to  make  the  bandage  firmer  (Fig.  105). 

The  starch  bandage  (common  boiled  starch)  is  very  useful,  easily 
made  and  can  be  used  in  the. smaller  dogs,  the  bandage  being  put  on  first 
in  one  layer,  this  carefully  covered  with  the  starch,  this  covered  with  a 
layer  of  muslin,  then  starch  over  this  and  finally  the  third  layer  covered 
with  starch  and  allowed  to  dry.  This  bandage  takes  longer  to  di-y  than 
the  plaster. 

Pitch  plaster  bandages  are  put  on  those  parts  of  the  body  where  an 


332 


DISEASES  OF  THE  ORGANS  OF  LOCOMOTION 


ordinary  bandage  cannot  be  applied,  as  in  fracture  of  the  scapula,  femur 
and  humerus.  The  pitch  can  be  spread  on  strips  of  coarse  muslin,  and 
heated  and  applied  to  the  injured  part  (Fig.  106).  Burgundy  pitch 
100.0  wax  50.0,  mix  this  into  a  plaster.  The  dressing  may  be  left  in 
place  until  we  feel  sure  that  union  has  taken  place.  In  cases  where  the 
dressing  has  been  too  tight,  or  if  the  patient  shows  restlessness,  whining, 
crying,  loss  of  appetite,  or  fever,  indicating  that  something  is  wrong  in 
the  fractured  region,  the  dressing  must  be  removed  at  once  (Fig.  107). 

"When  the  average  period  of  union  of  fracture  has  passed  remove 
the  dressing  carefully  and  see  that  the  fragments  are  united.  If  we 
recognize  any  mobility  in  the  fractured  region,  we  then  understand  that 
we  have  a  slow,  callous  formation,  and  nothing  else  is  to  be  done  but  to 

renew  the  dressing  as  soon  as  possible,  hav- 
ing first  rendered  the  parts  antiseptic  by 
means  of  sublimate,  soap  and  Avater.  Put 
on  the  l^andage  again  and  let  it  remain 
for  two  or  three  weeks  more.  If  we  do 
not  obtain  a  cure  at  the  end  of  that  time 


Fig.  106. — Pitch  plaster  put  on 
in  layers.     (.Cadiot- Breton.) 


Fig.  107.— Effects    of  tight 
bandaging  of  a  splint. 


we  may  conclude  that  we  have  a  false  joint  (pseudarthrosis). 

The  methods  pursued  in  man  of  introducing  ivory  or  bone  pins  into 
the  Ijone  or  screwing  it  together  by  means  of  clamps  or  resecting  the 
ends  with  a  saw,  is  hardly  practicable  in  the  dog.  If,  however,  we  dis- 
cover that  there  is  any  danger  of  the  formation  of  a  false  joint,  we  may 
daily  irritate  the  ends  of  the  wound  by  rubbing  the  broken  ends  together, 
and  tying  a  thick  elastic  band  around  the  leg  above  the  fractured  ends 
of  the  bone  for  one-half  to  one  hour  each  day  to  allow  an  engorgement  of 
blood  around  the  fracture,  this  bandage  should  not  be  made  too  tight  so 
as  to  interfere  with  the  arterial  circulation  but  sufficient  to  cause  venous 
engorgement  aliout  the  fracture;  others  recommend  injections  of  3  per 
cent  solution  of  carbolic  acid,  or  GO  per  cent,  of  alcohol,  and  appl3dng  a 
dressing,  giving  the  animal  phosphate  of  lime  or  phosphoric  acid. 


FRACTURES  OF   THE  BONES 


333 


In  complete  fractures  we  follow  the  same  rules  as  in  the  subcutaneous 
forms — that  is  to  say,  we  endeavor  in  one  way  or  another  to  hold  the 
broken  ends  of  the  bone  together  while  the  wound  is  healing,  and  at  the 
same  time  to  dry  up  the  wound  with  antiseptic  applications.  This  is 
rather  difficult  to  do  in  the  dog,  but  it  may  be  accomplished  by  making 
a  "  window  "  or  hole  in  the  dressing.  The  wound  must  first  be  thoroughly 
cleansed,  dressed  antiseptically,  and  then  we  apply  a  plaster  dressing, 
according  to  the  usual  method,  and  place  a  piece  of  wadding  upon  the 
Avound.  "When  the  dressing  becomes  hardened,  we  cut  a  hole  over  the 
wound  by  means  of  a  probe-pointed  bistoury,  coating  the  edges  of  the 
opening  with  a  small  quantity  of  plaster-of-Paris  or  collodion  in  order 
to  prevent  the  discharge  of  pus,  etc.,  from  running  under  the  dressing. 


Fig.  108. — Different  methods  of  amputation:  a,  straight  section;  b,  flap  operation;  c,  method  of  sewing 

the  wound. 

The  rest  of  the  operation  is  performed  according  to  the  general  rules 
followed  in  the  treatment  of  wounds.  In  cases  where  the  fracture  is 
fresh  and  the  wound  is  very  small,  we  cover  it  with  an  antiseptic  dressing 
(for  instance,  tincture  of  iodine  and  several  layers  of  corrosive  sublimate 
gauze).  Then  apply  the  closed  dressing  of  plaster-of-Paris  entirely 
over  it.  If  the  wound  is  slight,  as  a  rule  you  do  not  have  to  remove 
the  bandage.  Care  must  be  taken,  however,  to  take  the  temperature 
and  watch  the  leg  to  see  if  it  swells,  and  if  the  animal  is  restless  and  uneasy. 
In  cases  where  there  is  a  wound  and  several  broken  bones,  makmg  a 
compound,  comminuted  fracture,  the  patient  can  only  be  saved  by 
amputating  the  leg.  Amputation  of  the  leg,  as  well  as  exarticulation, 
has  been  performed  a  number  of  times  in  the  dog,  and  generally  success- 


334  DISEASES  OF  THE  ORGANS  OF  LOCOMOTION 

fully,  the  animals  soon  becoming  accustomed  to  the  loss  of  the  leg,  using 
the  other  three  with  almost  as  much  ease  as  they  did  the  four. 

Amputation. — Before  the  operation  clean  the  affected  leg  with  soap 

and  with  a  Inrush;  then  disinfect  with  powerful  antiseptics  (5  per  cent. 

solution  of  carbolic  acid,  1  to  1000  solution  of  corrosive  sublimate,  or 

2  per  cent,  solution  of  creolin).     In  operating,  the  animal  is  put  under 

ether  or  narcotized  in  some  way;  do  so  with  as  little  loss  of  blood  as 

possible.    To  accomplish  this,  use  a  rubber  bandage  as  a  tourniquet. 

All  of  the  rules  of  antisepsis  must  be  strictly  adhered  to,  and  at  short 

intervals,  during  the  operation  the  wound  must  be  irrigated  \\\i\\  some 

antiseptic.     Avoid  any  serious  manipulation  or  compression  of  the  soft 

parts,     The  skin  must  always  be  cut  in  such  a  manner  as  to  cover  the 

stump  when  the  two  ends  or  flaps  are  united.     All  the  vessels,  arteries 

as  well  as  the  veins,  which  have  been  cut  must  be  taken  up  separately 

with  the  forceps,  and  ligated  with  catgut  or  silk.     All  stumps  of  nerves 

which  lie  loose  upon  the  wound  are  to  be  drawn  out  with  the  forceps  and 

cut  off  as  close  as  possible.     The  bandage  must  not  be  removed  until  all 

the   blood  vessels  have  heen  ligated    (Fig.   108).      The  wound  and  its 

neighborhood  are  then  thoroughly  irrigated  with  an  antiseptic  solution 

and  closed  with  stitches,  as  illustrated  on  page  333,  Fig.  108,  c;  and  307, 

Fig.  118,  a  and  b.     The  whole  wound  is  to  be  covered  with  a  permanent 

antiseptic  dressing.     For  further  details,  see  Treatment  of  Wounds. 

There  are  three  methods  at  the  disposal  of  the  operator. 

(1)   Amputation  by  Means  of  a  Circular  Section. — Cut  through  the 

skin  of  the  affected  extremity  to  the  fascia,  making  a  complete  circle 

around   the   member.       Pull   back   the   skin   and   have   it   held   by   an 

assistant,  he  pulling  the  skin  toward  the  body  as  far  as  possible.      It  may 

be  necessary  in  some  instances  to  dissect  a  small  portion  of  the  skin  and 

the  cellular  tissue  from  under  the  layer  of  the  skin.      After  that  make  a 

sharp,  clean  circular  cut,  close  to  the  edge  of  the  skin  which  is  pulled 

back,  amputating  all  the  muscles,  and  then  cut  the  bone  with  bone  forceps 

(Fig.  108,  a),  or  saw  through  the  bone.     "While  cutting  through  the  bone 

it  is  necessary  for  the  assistant  to  pull  back  the  soft  tissues  as  far  as  he 

possibly  can  toward  the  body,  either  with  his  hands  of  by  means  of  a 

linen  compress  which  has  been  dipped  in  an  antiseptic  solution.     In 

cases  where  amputation  of  the  extremities  is  to  be  performed,  where 

there  are  two  bones,  as  in  the  forearm,  it  is  necessary  to  cut  the  soft 

tissues  that  are  located  between  the  bone. 

Flap  Amputation. — This  is  made  by  cutting  two  half-moon-shaped 
flaps  of  the  skin  and  separating  them  from  the  fasciie  in  which  they  are 
located  as  far  as  their  base,  turning  them  upward  and  backward.  The 
muscles  are  cut  close  to  the  flaps,  the  tissues  pulled  back,  and  the  bones 
sawed  through  and  the  ends  of  the  fjap  carefully  stitched  (Fig.  108,  h). 


MINOR  DISEASES  OF  THE  BONES 


335 


Exarticulation. — Separate  the  soft  parts  exactly  as  in  amputation 
by  means  of  a  circular  or  flap  operation.  Then  open  the  affected  joint 
by  bending  it,  producing  a  tension  of  the  ligaments  which  are  located  in 
front  of  it;  then  cut  through  them  with  a  bistoury.  To  get  quicker 
adhesion  of  the  tissues  it  is  best  to  scrape  the  cartilage  on  the  face  of  the 
articulation.  Exarticulation  is  finished  by  separating  the  other  liga- 
ments and  the  capsule  of  the  joint;  then  proceed  exactly  as  we  do  in 
ordinary  amputation.  The  operation  of  removal  of  the  tail  is  taken 
up  later. 

Minor  Diseases  of  the  Bones. 

Other  disease  of  the  bones  in  the  dog  are  of  slight  importance  but 
the  following  are  mentioned: 


Fig.    109.  Fig.    110. 

Fig.   109. — Skiagraph  of  osteosarcoma  of  the  radius  with  opening  in  the  upper  part 

of  the  bone. 
Fig.  110. — Skiagraph  of  the  ulna  with  middle  and  lower  third  of  the  bone  nearly  gone. 

Osteomalacia.  Softening  of  the  Bone. — This  condition  has  no  con- 
nection with  rickets,  but  a  softening  of  a  l:)one  after  the  bone  has  become 
hard  and  perfectly  formed.  It  is  a  question  if  this  disease  really  ex- 
ists in  the  dog.  Zscholke  states  he  has  seen  numbers  of  cases  where 
there  was  great  loss  in  the  substance  of  the  bone,  but  at  the  articulatory 
surfaces  there  was  no  evidence  of  rickets;  another  observer  treated  a  dog 


33G  DISEASES  OF  THE  ORGANS  OF  LOCOMOTION 

■with  an  enormous  swelling  of  the  inferior  maxillary  and  on  minute  ex- 
amination of  the  bone  there  was  lacunary  atrophy. 

Ostitismus  Universalis  and  Hyperostosis  et  Myostosis  Universalis 
Progressiva. — This  is  a  peculiar  affection  of  young  clogs.  It  is  indicatetl 
])y  numerous  nodules  of  bone  at  the  insertion  of  many  muscles  of  the  body, 
and  great  increase  in  the  lime  salts  of  bones  and  also  of  weight  of  the 
skeleton.  It  has  been  observed  by  Kitt  where  an  animal  had  an  enor- 
mous swelling  of  the  head  the  lower  jaw  and  the  bones  of  the  legs  partic- 
ularly the  bones  of  the  forearm,  while  the  other  bones  of  the  body  were 
entirely  free  from  any  sign  of  the  disease.  The  animal  suffered  no  in- 
convenience from  the  condition,  had  no  fever,  appetite  good  and  general 
health  was  excellent.  The  deformity  of  the  skeleton  made  walking 
irregular  and  difficult,  and  the  animal  moved  around  with  a  wave  like 
motion  of  the  body. 

Multiple  Periostitis. — This  condition  is  extremely  rare,  there  is 
generally  more  or  less  rheumatism  and  deposits  in  the  articular  ends 
of  the  bones,  probably  a  complication  of  gout. 

Neoformations  of  the  Bones. — Osteophytes  and  exostoses,  so  often 
seen  in  other  of  the  domestic  animals,  are  extremely  rare  in  the  dog. 
Sarcomata  (osteo  sarcoma),  on  the  other  hand,  appear  in  a  variety  of 
ways  developing  from  the  periosteum  or  directly  from  the  marrow  canal 
of  bones,  or  in  the  inferior  maxillary  causing  a  tumefaction  of  the  gum. 
The  writer  has  observed  two  cases  in  the  radius  and  ulna,  which  were 
illustrated  by  means  of  the  Rontgen  rays  (X-rays),  the  destruction  and 
alteration  of  the  bones  could  be  readih^  distinguished,  numerous  cases 
have  been  observed  by  other  observers. 


DISEASES  OF  THE  ARTICULATIONS. 
INFLAMMATION  OF  THE  JOINTS. 

General  Pathological  Anatomy  of  Inflammation  of  the  Joints. — A 

common  aft'cction  of  the  joints  is  synovitis.  In  a  simple  case  of  in- 
flammation of  the  joints,  we  see  an  increase  of  blood  vessels,  an  in- 
filtration of  the  small  cells,  and  even  disintegration  of  the  endothelial 
cartilage;  the  tissue  under  it  becoming  granular.  We  find  cjuite  freciuently 
an  accumulation  of  fibrinous  or  "  croupal-like  "  membranes,  followed  by 
a  cicatrization  of  the  synovial  membrane.  In  all  acute  forms  of  synovitis 
we  see  hemorrhages  in  the  form  of  small,  tick-like  bodies.  In  inflamma- 
tion of  the  joints,  when  it  takes  a  chronic  form,  the  synovial  membrane 
becomes  thickened,  is  tougher,  with  marked  indentations  on  the  membrane 
which  are  tree-like  in  form.  The  synovia  appears  in  large  quantities, 
is  yellowish,  clear,  or  slightly  turbid,  and  dulled  l^y  cells  or  fibrinous 
flakes.  If  the  synovia  is  gathered  in  a  large  quantity,  we  find  a  dis- 
tention of  the  capsule,  producing  a  hernia-like  protrusion  of  those  parts 
of  the  joint,  where  there  is  the  least  resistance.  Occasionally  we  find 
the  synovial  membrane  covered  with  thick  clotted  masses.  These  oc- 
cur from  the  excessive  secretion  of  synovia  in  the  joints.  Sometimes 
small  bodies  appear  in  the  joints  due  to  some  parts  of  the  hard  cartilage 
becoming  detached  and  in  rare  instances  by  a  breaking  off  of  small 
pieces  of  bone,  and,  finally,  we  may  see  the  development  of  a  cicatricial 
contraction  of  the  synovial  membrane;  which  is  due  to  an  acute  or 
chronic  inflammation  of  the  joints,  or  when  for  any  cause  (for  instance, 
dressing  of  fractures)  a  healthy  joint  is  rendered  immovable  for  some 
time.  This  condition  may  produce  a  temporary  stiffening  of  the  joint, 
but  this,  as  a  rule,  is  overcome  in  a  short  time. 

The  fibrous  capsule  of  the  joint  is  occasionall}^  inflamed,  but,  as  a 
rule,  in  acute  and  chronic  inflammation  of  the  joint  it  remains  unaffected. 
"Where  there  is  suppuration  present  the  capsule  may  become  detached 
from  the  periosteum  with  the  bone,  and  also  may  be  perforated  by  the 
pus.  The  ligaments  also  become  impregnated  with  the  pus  from  a 
purulent  inflammation,  but,  they  are  rarely  destroyed.  Occasionally, 
however,  we  may  see  chronic  inflammation  of  the  joints  in  which  there 
is  a  cicatricial  contraction,  where  the  joints  become  firm  and  united, 
and  their  mobility  is  lost.  Sometimes  from  traumatisms  we  find  only  the 
soft  parts  which  surround  the  joint,  such  as  the  external  ligaments  or 
the  neighboring  tendons,  become  involved  in  the  inflammatory  process, 
while  the  inner  joint  seems  to  be  very  little  affected. 
22  337 


338  DISEASES  OF   THE  ARTICULATIONS 

The  cartilage  of  the  end  of  the  joints  is  rarely  affected  by  the  various 
inflammatory  conditions.  In  acute  cases  of  suppuration  of  the  joints, 
the  cartilage  may  he  softened,  perforated,  or  partially  destroyed,  so 
that  the  bone  is  bare  in  some  places.  In  many  chronic  cases  of  inflam- 
mation of  the  joints  the  cartilage  becomes  macerated  and  dissolved  into 
fibres,  or  it  may  be  overgrown  with  abnormal  synovial  extensions.  As 
soon  as  the  bone  proper  becomes  involved  in  the  inflammatory  process, 
extensive  granulations  form,  causing  a  peculiar  spongy  growth  on  the 
cartilage.  These  granulations  crowd  and  perforate  the  bone  here  and 
there  and  also  affect  a  cartilage  of  the  opposing  bone,  leading  to  a  cic- 
atricial growth  on  the  end  of  the  joint.  In  some  cases  we  also  see  the 
fibres  and  cells  of  the  cartilage  becoming  soft  and  finally  growing  up  with 
numerous  raised  cartilaginous  cells,  and  presenting  an  acute  inflammation 
of  the  ends  of  the  joints.  From  these  periodical  conditions  we  may  find 
a  marked  alteration  in  the  form  of  the  joint  in  which  the  edges  of  the 
joint  protrude,  and  the  inner  surface  is  hollowed  and  grooved.  A 
peculiarity  of  deforming  inflammation  of  the  joints  is  an  inflammation  of 
the  synovial  membrane,  with  abnormal  excretion  of  synovia  and  a  great 
enlargement  of  the  free  or  loose  portion  of  the  membrane  which  may 
develop  into  papilla-shaped  masses. 

The  bone,  as  a  rule,  does  not  become  affected  in  acute  inflammation 
of  the  joint;  but  if  it  should  become  uncovered  from  suppuration  of  the 
cartilage,  the  inflammation  extends  to  the  spongiosa,  and  we  see  occasion- 
ally the  formation  of  purulent  or  granular  centres  on  the  surface  of  the 
bone.     In  rare  cases  the  periosteum  becomes  covered  with  osteophytes. 

Acute  Synovial  Inflammation  of  the  Joints. 

{Synovitis  Acuta  Serosa.) 

The  joint  is  swollen  and  hot,  and  the  animal  shows  pain  on  pressure 
or  movement  of  it.  These  symptoms  indicate  an  inflammation  of  the 
synovial  membrane  and  a  lessening  of  the  secretion  of  synovial  fluid 
in  the  joint.  It  is  very  rare  that  we  see  intense  fibrinous  excretions 
(synovitis  sero-fibrinosa) ,  and  still  more  rare  are  those  cases  of  colorless 
blood-cells  mixed  with  detached  epithclia.  The  animals  are  lame  when  the 
joint  is  moved,  especially  at  the  beginning  and  toward  the  end  of  any 
movement  of  the  joint.  Very  frequently  small  dogs  will  only  walk  on 
three  feet,  carrying  the  inflamed  member. 

The  following  causes  may  produce  synovitis:  Crushing  or  con- 
cussion of  the  joint,  ])lows,  sprains  (such  as  falling  from  a  height).  In 
cases  of  injuries  of  the  joints,  we  may  expect  only  a  simple  synovitis 
when  the  injuring  object  is  clean  and  the  wound  is  cleansed  immediately 
after   the   injury    (removing   the   blood-clots   and   applying   antiseptic 


INFLAMMATION  OF  THE  JOINTS  339 

dressing).  According  to  tho  olx-^orvations  of  the  writer,  acute  synovitis 
occurs  most  frequently  in  the  carpal  joint,  joints  of  the  toes,  in  the  knees, 
and  hip-joints.  Paint  the  affected  joint  with  iodine  and  keep  the  leg  at 
rest  as  much  as  possible.  After  the  acute  symptoms  have  subsided,  mas- 
sage the  joint  and  allow  light  exercise. 

There  are  several  irritations  of  the  joints  that  are  observed  in  the 
work  dogs  of  Europe  that  are  not  of  interest  to  the  English  speaking 
reader. 

The  course  of  synovial  inflammation  of  the  joints  is,  as  a  rule,  rapid. 
If  the  patient  receives  proper  treatment,  in  a  short  time  we  see  an  im- 
provement (especially  if  the  animal  gets  complete  rest) .  In  other  cases 
the  disease  takes  a  chronic  form — that  is,  it  may  form  one  of  the  follow- 
ing conditions:  (1)  Chronic  Serous  Inflammation  of  the  Joints  (Synovitis 
Chronica  Serosa).  In  this  the  joint  is  slightly  swollen  and  painful, 
also  very  feverish.  In  some  cases  we  may  see  a  fluctuating  sw^elling  as 
a  result  of  enlargement  of  the  capsule  by  serous  secretion.  If  the  disease 
is  still  more  acute,  we  may  have  a  thickening  of  the  fibrous  capsules,  and 
very  frec^uentl}'  qviite  an  enlargement  starting  from  the  edge  of  the  joint. 
Chronic  synovitis  may  appear  in  the  onset  of  the  disease,  but,  as  a  rule, 
it  results  as  a  consequence  of  the  acute  form.  The  writer  has  seen 
these  cases  in  the  carpus  and  knee-joint.  The  lameness  is  not  especially 
marked,  l^ut  any  active  movements  increase  it  very  much.  (2)  Purulent 
Inflammation  of  the  Joints:  Suppuration  of  the  Joints  (Py arthrosis). 
While  the  two  forms  which  have  before  been  descriljed  are  rarely  accom- 
panied by  fever,  it  is  quite  different  in  suppuration  of  the  joint.  In  this 
there  is  great  fever  from  the  onset,  which  is  ushered  in  by  a  chill.  We 
may  see  a  more  or  less  rapid  swelling  of  the  joint,  which  is  extremely 
painful.  The  joint  is  kept  in  a  bent  or  flexed  position,  and  the  patient 
walks  on  three  feet.  We  may  also  see  an  oedematous  swelling  extending 
both  above  and  below  in  the  neighborhood  of  the  joint.  The  temperature 
is  considerably  increased  in  some  cases;  the  skin  appears  either  normal  or 
reddened,  sometimes  even  bluish  red.  The  pus  may  eventually  break 
through  the  skin  in  the  neighborhood  of  the  joint  or  it  may  lie  in  the 
joints,  become  absorbed,  and  cause  pya'mia. 

This  termination  will  occur  even  when  the  pus  has  broken  out  ex- 
ternally, and  in  some  cases  where  the  inflammation  has  been  very  acute 
we  may  have  a  subsequent  adhesion  of  the  joint  (ankylosis). 

Suppuration  of  the  joints  is  frequently  produced  by  infected  wounds 
at  or  near  the  joint.  In  rare  instances  it  may  be  the  result  of  a  phleg- 
monous inflammation  in  the  neighborhood  of  the  joint;  concussion  or 
crushing  may  also  cause  it,  or  it  may  occur  in  a  metastatic  way.  Such 
inflammations  of  the  joints  may  also  occur  as  a  purely  suppurative  in- 
flammation; but,  as  a  rule,  the  inflammations  are  sero-fibrinous  or  sero- 


340  DISEASES  OF  THE  ARTICULATIONS 

purulent,  and  with  it  we  may  see  purulent  centres  of  abscesses,  and 
followed  by  pyteniia;  or  the  development  of  the  disease  in  several  joints 
at  the  same  time,  or  developing  one  after  the  other  at  short  intervals. 
The  writer  saw  metastatic  suppuration  of  the  joints  of  the  knee,  carjDus, 
and  toes. 

Rheumatic  Inflammation  of  the  Joints. 

(Rheumatic  Arthritis.) 

Articular  Rheumatism,  Polyarthritis  Rheumatica. 

This  condition  is  evidently  an  infectious  disease  accompanied  by 
more  or  less  fever,  being  rare  in  the  dog,  and  indicated  by  a  sero-fibrinous 
synovitis  of  several  of  the  articulations. 

Etiology. — The  actual  cause  of  the  disease  has  not  been  separated 
and  described,  some  observers  are  inclined  to  think  that  it  is  not  due  to  a 
specific  microorganism^  but  that  it  is  produced  by  a  series  of  different 
bacteria,  particularly  the  streptococci  and  staphylococci,  and  these 
produce  a  mild  septic  infection.  If  this  theory  is  correct,  then  this 
disease  is  closely  related  to  these  inflammations  of  the  articulations 
which  occasionally  follow  infectious  disease.  It  is  caused  by  cold,  es- 
pecially in  shooting  clogs,  if  used  in  cold  weather  or  during  winter, 
when  they  become  very  wet  and  lie  around  in  a  draught  or  from  cutting 
the  hair  off  in  cold  weather  and  keeping  animals  in  cold  kennels. 

Clinical  Symptoms  and  Course. — There  are  two  forms  of  this  disease: 
an  acute  and  a  chronic  form.  The  former  appears  suddenly,  the  animal 
becoming  very  lame  in  one  or  more  of  the  articulations  in  which  there 
appears  a  serous,  but  more  rarely  sero-purulent  synovitis  accompanied 
by  great  pain,  high  fever,  loss  of  appetite,  great  depression,  and  consti- 
pation. The  lameness  is  much  greater  than  in  any  other  form  of  joint- 
irritation,  Very  often  several  joints  become  diseased  at  one  time,  or 
the  disease  may  go  from  one  joint  to  another;  if  the  joint  is  moved,  or 
the  animal  disturbed  it  causes  great  pain,  sometimes  agony;  and  while 
any  articulation  in  the  l)ody  may  he  attacked,  the  elbow  and  the  carpal 
articulations  seem  to  be  attacked  most  frequently,  less  so  the  ankle  and 
hip.  Occasionally  we  find  as  complications  of  this  disease,  pericarditis, 
pleuritis  and  peritonitis. 

When  the  disease  takes  a  chronic  form,  either  from  the  onset,  or 
merges  into  the  chronic  from  the  acute  stage,  it  resembles  very  much 
chronic  sero-synovitis.  There  is  gi'eat  thickening  of  the  capsule,  and 
sometimes  the  formation  of  adhesions  between  the  surfaces  of  the  joints 
and  the  connective  tissue,  and  in  I'ure  instances  we  may  have  ankylosis 
of  the  joint.  AVhile  the  diagnosis  is  rather  difficult  where  the  disease 
is  confined  to  one  joint  it  is  easily  distinguished  when  you  see  it  appear 


MALFORMATION  OF  THEJOINTS  341 

in  several  joints  at  once,  and  also  from  the  fact  that  it  may  move  from  one 
joint  to  another. 

Therapeutics. — The  treatment  is  the  same  as  in  muscular  rheum- 
atism. Keep  the  animal  warm,  quiet,  and  wrap  the  affected  joints 
in  flannel,  raw  cotton,  and  frictions  of  spirits  of  camphor,  oil  of  camphor, 
ichthyol,  or  thigneol  ointments.  Internal  adminstrations  of  salol,  salipy- 
rin,  salophen,  plenacctin,  and  mild  saline  laxatives.  When  the  case  is 
chronic,  joints  may  be  painted  with  tincture  of  iodine,  and  when  the 
fever  lessens  daily  massage  the  joints.  A  careful  examination  of  the 
heart  should  be  made  from  time  to  time  during  the  course  of  the  disease. 

Disease  Producing  Malformation  of  the  Joints. 

(.1  rthritis  DeJ'onnans.) 

The  cause  of  this  disease  is  very  little  known.  It  is  very  probably 
due  to  a  chronic  rheumatism,  or  to  some  inflammation  of  the  joint.  It 
may  also  be  due  to  great  exertion,  and  is  especially  seen  in  Holland  or 
Canada  and  Alaska  where  animals  are  used  to  pull  carts  and  vehicles  or 
sleds  and  in  coach  dogs  that  run  after  carriages,  and  occasionally  seen 
in  pointers  and  setters  that  are  constantly  hunted.  The  first  symptom  of 
this  disease  is  a  slight  lameness  in  the  diseased  joint.  This  lameness 
may  be  overlooked,  as  it  is  generally  very  slight,  and  after  the  animal  has 
taken  a  little  exercise  it  gradually  disappears,  although  in  some  rare 
cases  the  lameness  may  continue,  or  even  with  exercise  become  ag- 
gravated. In  the  early  stages  of  the  disease  there  is  no  indication  of 
pain  on  movement  or  pressure  of  the  joint,  but  later  on,  pain  on  pressure 
and  motion  begins  to  show  itself.  At  the  same  time  there  is  a  gradual 
swelling  and  thickening  of  the  capsule  of  the  joint,  with  apparently  a 
loss  of  the  normal  amount  of  synovia.  Sometimes  we  notice  a  slight 
heat.  A  peculiar  symptom  of  this  disease,  which  is  noticed  from  the 
very  onset,  is  a  peculiar  creaking  or  crepitating  sound  when  the  joint  is 
moved.  After  a  time  stiffness  of  the  joints  becomes  more  marked. 
There  are  hard  swellings  on  the  cartilaginous  borders,  also  a  tendency 
of  the  ends  of  the  joint  to  enlarge,  and  finally  marked  alteration  in  the 
form  of  the  joint.  By  these  changes  we  are  enabled  to  distinguish  be- 
tween arthritis  deformans  and  chronic  serous  inflammation  of  the  joints. 

The  anatomical  alterations  have  already  been  mentioned.  Ar- 
thritis deformans,  as  a  rule,  occurs  in  the  knee-joint,  the  elbow  and 
shoulder.  The  prognosis  of  this  disease  is  always  to  be  unfavorable,  be- 
cause it  seems  to  defy  medical  treatment,  going  on  until  finally  the 
joint  becom<'s  a  large  unsightely  mass. 

Therapeutic  Treatment  of  Inflammation  of  the  Joints.— In  all  cases, 
except  those  of  slight  synovitis,  the  joint  must  be  kept  as  quiet  as  pos- 


342  DISEASES  OF  THE  ARTICULATIONS 

silile.  In  simple  cnses  the  animal  should  be  kept  in  a  kennel  or  in  a 
room  for  several  days.  In  serious  cases  where  no  operation  seems  to 
be  required,  and  there  is  no  danger  of  poison  breaking  through  the  joints, 
and  where  the  inflammatory  swelling  is  not  very  great,  it  is  best  to  ap]:)ly 
the  l)andage  of  cotton  and  dress  over  that  with  a  plaster  or  silicate  of 
sodium  bandage,  treating  it.  the  same  as  a  fracture.  The  writer  has 
ol)tained  very  good  results  with  this  method  in  the  carpal,  tarsal,  and  toe- 
joints.  Albrecht  advises  that  the  joints  should  be  rubbed  with  a  thick 
layer  of  citrine  ointment  before  applying  the  dressing.  (For  further 
details,  see  under  head  of  Dressings,  etc.) 

It  is  well,  however,  to  take  into  consideration  one  point:  that  the 
dressing  must  be  in  such  a  position  as  not  to  interfere  with  the  use  of  the 
leg.  With  the  alcove  treatment  we  generally  obtain  good  results  in  a 
short  time.  In  the  serious  forms  of  the  disease,  and  where  the  tlressing 
cannot  be  used  on  account  of  the  position  of  the  joint,  we  must  apply 
such  local  applications  as  will  al)ate  the  inflammation.  As  a  rule,  the 
best  treatment  is  cold-water  applications  containing  lead  or  arnica.  In 
cases  where  there  are  great  pain  and  acute  rheumatic  inflammation  of  the 
joint,  it  is  better  not  to  apph'  too  much  cold  water,  but  use  instead 
Priessnitz's  compress.  Wrap  the  joint  in  a  piece  of  linen  which  has  been 
folded  several  times,  similar  to.  a  handkerchief,  and  then  cover  it  with 
some  impervious  object,  such  as  oil-cloth,  silk,  rubber,  or  a  woolen  cover. 
If,  for  some  reason,  neither  the  cold  nor  moist  treatment  is  practicable, 
we  must  paint  the  part  with  tincture  of  iodine  once  or  twice  daily,  and  the 
fluid  must  be  rubl)ed  into  the  skin  by  means  of  a  rag.  The  writer  has 
never  had  very  good  results  from  this  method  of  treatment,  but  painting 
with  iodine  produces  better  results  than  any  of  the  liniments,  such  as 
camphor  or  soap  liniment.  Massage  has  been  found  to  produce  good 
results  in  many  diseases  of  the  joints  in  dogs,  although  it  has  not  been 
used  very  extensively  by  canine  practitioners.  In  chronic  cases  where 
there  are  great  thickening  and  a  large  qiuintity  of  secretion  of  the  capsule, 
as  in  cases  of  acute  inflammation  of  the  joint,  or  in  purulent  arthritis, 
massage  with  cocoanut  oil  is  particularly  adapted.  In  cases  of  rheumatic 
inflammation  of  the  joint,  which  have  been  recognized  as  such,  we 
must  use  internal  remedies,  such  as  recommended  in  muscular  rheu- 
matism. 

In  many  traumatic  and  purulent  inflammations  of  the  joint  we  can 
only  get  good  results  by  an  operation  which  varies  acconling  to  the  con- 
dition.    The  general  procedure  is  as  follows: 

Puncturing. — This  method  of  treatment  is  indicated  in  all  chronic 
serous  secretions  of  the  joint.  As  soon  as  we  find  that  the  measures 
which  encourage  reabsorption,  such  as  tight  dressing  and  massage,  do 
not  produce  good  results,  and  where  the  secretion  causes  great  distention 


MALFORMATION  OF  THE  JOINTS 


343 


of  the  capsule,  and  where  there  are  great  lameness  and  indications  of 
suppuration,  we  proceed  in  the  following  manner: 

(a)  The  part  to  be  punctured  must  be  rendered  strictly  aseptic;  (b) 
the  part  must  have  a  particularly  tight  dressing  over  it  for  a  few  days 
after  the  o])eration. 

If  this  latter  method  is  not  practicable  on  account  of  the  position  of 
the  joint  or  some  other  circumstance,  puncturing  the  joint  will  not  give 
favorable  results  and  maj^  even  lead  to  very  serious  conditions  (suppura- 
tion, etc.).     The  method  of  operation  is  very  simple. 

After  having  removed  the  hair  from  the  region  of  the  joint  and  wash- 
ing with  sublimated  soap,  disinfecting  it  with  a  5-pcr  cent,  solution  of 
carbolic  acid  and  2  per  cent,  of  creolin  or  1  per  cent, 
of  corrosive  sublimate,  we  then  puncture  the  part  with 
a  good-sized  hypodermatic  needle  and  slowly  evacuate 
the  sac  by  drawing  it  into  the  syringe.  If  the  syringe 
becomes  filled  and  the  joint  is  not  entirely  emptied,  the 
syringe  must  be  detached  from  the  needle  and  the 
opening  closed  at  once  by  means  of  the  finger,  as  any 
air  that  may  find  its  way  into  the  joint  will  produce  bad 
results.     Empty  the  syringe  and  proceed  as  before. 

This  method,  as  a  rule,  is  absolutely  harmless, 
evacuating  the  sac  in  cases  of  serous  secretions.  If, 
however,  we  find  in  the  fluid  withdrawn  from  the  joint 
many  cellular  elements — that  is  to  say,  if  it  possesses  a 
marked  purulent  character — we  must  use  at  the  same 
time  an  injection  of  antiseptic  fluid  directly  into  the 
joint,  so  as  to  make  it  aseptic.  For  that  purpose  we 
use  a  slightly  warm  solution  of  corrosive  sublimate  1 
to  1000  or  a  2-per  cent,  solution  of  carbolic  acid  and  a 
Lugol  solution  of  iodine  (1  per  cent,  tincture  of  iodine,  ,     ^°:  ^^^■~'    ^^^^ 

~  ^      i  '    hypodermatic  syringe 

2  per  cent,  of  iodide  of  potassium,  and  5U  per  cent  of  for  puncturing  en- 
water).  Either  of  these  solutions  ma}'  be  injected  ^'^^^  jomts. 
through  the  needle  into  the  joint;  then,  by  manipulation,  try  to  work 
this  solution  inside  of  the  capsule  by  means  of  careful  pressure, 
allowing  it  to  flow  out  through  the  needle  in  one  or  two  minutes.  The 
needle  is  then  withdrawn  and  the  perforated  opening  is  closed  at  once 
by  means  of  an  iodoform  tampon,  and  over  that  an  antiseptic  dressing- 
is  placed.  This  should  be  allowed  to  remain  on  the  wound  for  a  few 
days. 

(For  further  particulars,  see  the  chapter  on  Treatment  of  Wounds.) 

In  chronic  inflammations  or  great  secretions  we  may  also  use  simple 

injections  of  disinfecting  solutions,  such  as  iodide  of  potassium,  as  a  means 

of  reducing  the  inflammation  or  destroying  its  products.     "We  perforate 


344  DISEASES  OF  THE  ARTICULATIONS 

directly  into  the  cavity  of  the  joint  by  means  of  a  hypodermatic  needle  and 
with  a  syringe  inject  a  quantity  of  fluid  in  proportion  to  the  size  of  the 
joint.  This  operation  has  to  be  repeated  every  three  or  four  days,  fol- 
lowing the  same  procedure  before  and  after  the  operation  as  has  been 
already  described. 

The  joint  may  he  opened  by  means  of  a  puncture  ivith  a  lancet.  This  is 
advisable  where  there  is  extensive  suppuration  going  on  in  the  joint  and 
where  the  diseased  part  shows  every  indication  of  a  septic  condition. 
The  joint  to  be  opened  should  be  punctured  by  means  of  a  lancet  or  bis- 
toury, making  a  wound  just  sufficient  to  empty  it  freely.  It  must  then  l)e 
cleansed  with  an  antiseptic  solution  and  any  clots  or  detached  portions  of 
tissue  washed  out;  then  close  the  wound  by  means  of  sutures.  In  some 
cases  it  is  well  to  leave  one  corner  open  for  drainage,  that,  of  course,  being 
the  lower  one.     We  then  place  an  antiseptic  dressing  over  the  whole  part. 

Injuries  of  the  Joints. 

These  may  l^e  divided  into  several  groups — true  wounds  of  the 
joints,  contusions,  distortions,  and  luxations. 

Wounds  of  the  Joints. — Wounds  of  the  joints — that  is  to  say, 
injuries  which  expose  the  joint  proper  to  the  atmosphere — are  divided 
into  perforating  or  cutting  wounds,  being  produced  by  laceration,  con- 
tusion, and  shot. 

Clinical  Symptoms  and  Course. — The  first  symptom  of  injury  to  the 
joint,  as  a  rule,  is  a  discharge  of  synovia  from  the  wound.  This,  however, 
may  be  absent  in  cases  where  the  wound  is  very  fine,  or  where  the  punc- 
ture runs  in  an  oblique  direction;  the  amount  of  discharged  synovia,  as  a 
rule,  is  very  slight  at  the  beginning,  and  of  normal  consistency.  If  the 
wound  is  not  closed  immediately,  it  increases  in  amount  and  becomes 
thinner.  In  some  cases  it  is  difficult  to  tell  positively  whether  the  syno- 
via comes  from  the  joint  or  from  the  sheath  of  a  tendon.  In  the  latter 
case,  however,  the  amount  of  synovia  is  generally  very  slight.  Blood 
may  accumulate  in  the  cavity  of  the  joint  and  develop  a  haemarthrosis. 
In  some  cases  where  there  is  hemorrhage,  the  wound  may  be  very  small 
and  close  up  quickly,  or  it  may  lie  in  an  o]:)lique  direction  and  prevent 
the  escape  of  blood.  This  flows  into  the  joint  and  ffils  it  up.  Hannar- 
throsis  is  distinguished  from  serous  or  purulent  secretions  by  appearing 
shortly  after  the  injury,  and  the  absence  of  all  inflammatory  symptoms — 
that  is,  at  the  onset  of  the  disease. 

The  other  symptoms  of  wounds  of  the  joints  are  acute  sensitive- 
ness, the  animal  limping  and  showing  great  pain,  holding  its  leg  in  a 
flexed  condition.  Generally  the  external  opening  of  the  wound  can 
also  be  distinguished. 


IXJURIES  OF  THE  JOIXTS  345 

The  course  of  this  disease  differs  greatly  according  to  the  character 
of  the  wound  and  whether  the  object  that  caused  it  was  clean  or  not. 
ymall  perforating  wounds  heal  quickly,  and  the  animals  limp  only  for  a 
few  days.  In  serious  wounds  where  the  joint  has  been  exposed,  and 
dirt  or  other  foreign  l^odies  have  obtained  entrance  into  the  joint,  the 
prognosis  is  less  favorable.  In  such  cases  we  notice  a  great  discharge  of 
synovia.  This  is  clear  in  the  early  stage  of  the  disease,  but  soon  be- 
comes turliid  by  the  addition  of  pus-corpuscles  and  fibrinous  clots.  It 
then  becomes  flaky  and  finally  purulent.  At  the  same  time  there  is 
great  fever  around  the  joint,  which  is  swollen  very  much,  and  the  neigh- 
boring tissues  become  cedematous,  extending  in  all  directions.  We  may 
see  numerous  abscesses  forming  all  around  the  joint  or  in  the  inter- 
muscular connective  tissue,  and  finally  the  animal  dies  from  general 
exhaustion  or  pyaemia. 

According  to  the  circumstances  and  condition  of  the  wound,  the 
course  may  be  much  more  rapid.  The  synovia  becomes  purulent  in  a 
short  time;  septic  fever  shows  itself  ciuickly;  there  is  a  rapid  pulse;  the 
animal  sinks  into  a  coma,  and  dies  from  septicsemia.  This  may  even 
occur  in  slight  wounds,  if  they  have  not  been  treated  properly,  and 
where  thorough  disinfection  has  not  been  followed. 

Therapeutic  Treatment. — The  first  thing  to  do  after  an  injury  has 
occured  is  to  thoroughly  disinfect  the  wound  and  its  immediate  neighbor- 
hood. Clip  the  hair  from  all  around  the  part,  then  wash  it  with  a  solu- 
tion of  corrosive  sulDiimate,  and,  in  cases  where  the  puncture  is  very 
narrow,  clean  it  out  by  means  of  a  syringe  with  a  2  per  cent,  solution  of 
creolin  and  a  5  per  cent,  solution  of  carbolic  acid,  or  a  1  per  cent,  solution  of 
corrosive  sublimate.  If  you  find  the  object  which  caused  the  puncture 
was  very  dirty,  the  wound  must  be  enlarged  and  thoroughly  washed  with 
any  of  the  above-named  solutions.  The  wound  should  then  be  closed 
by  means  of  sutures,  taking  care  when  stitching  it  up  not  to  include  the 
synovial  membrane  or  any  part  of  the  joint  in  the  sutures.  It  is  well, 
however,  in  some  cases,  to  place  a  small  piece  of  catgut  or  silk  in  the 
lower  surface  of  the  wound  in  order  to  assist  in  emptying  the  joint.  We 
then  place  the  joint  in  an  antiseptic  dressing  and  cover  it  up. 

If  we  have  to  deal  with  a  wound  that  has  been  neglected  and  where 
suppuration  has  been  going  on  for  some  time,  and  the  owner  does  not 
wish  to  destroy  the  animal,  we  must  enlarge  the  wound  at  once,  and 
all  pockets,  or  sacs,  in  the  joint  must  be  emptied  and  washed  with  a  solu- 
tion of  corrosive  sublimate.  Any  clots,  masses,  or  pieces  of  tissue  must 
he  removed,  and  the  operation  finished  as  before  described.  In  all 
these  cases  the  animal  must  have  absolute  rest,  and  the  dressing  be 
renewed  frequently. 

Contusions  of  the  Joints. — Under  this  head  we  class  injuries  to  the 


34G  DISEASES  OF  THE  ARTICULATIONS 

joints  which  have  Iseen  caused  by  compression  of  the  soft  parts  against 
the  bones  or  from  shocks,  such  as  jumping  or  leaping  from  a  height, 
kicks,  and  where  the  extremities  have  been  run  over  by  vehicles.  In 
this  we  may  have  a  series  of  results,  such  as  crushing  or  laceration  of  the 
capsule  of  the  joint,  with  formation  of  ha^narthrosis,  or  a  concussion  or 
crushing  of  the  bone  with  little  escape  of  blood.  In  rare  instances  we 
may  see  a  laceration  of  the  cartilage. 

Clinical  Symptoms. — The  animal  shows  great  sensitiveness  and  pain 
on  manipulation  of  the  joint,  and,  as  a  rule,  carries  it  in  the  air.  There 
is  a  rapid  swelling  of  the  joint  and  oedema  of  the  surrounding  parts,  also 
a  high  temperature. 

Therapeutic  Treatment. — The  treatment  consists  in  cold-water 
applications,  if  the  position  of  the  joint  admits,  renewed  constantly. 
The  best  method  is  to  soak  a  piece  of  absorbent  cotton  in  water,  lay 
it  on  the  joint  and  bandage  it  up  lightly,  moistening  it  in  cold  water 
from  time  to  time.  In  old  cases  use  friction  (massage)  of  the  joint 
in  a  circular  direction  (twice  daily  for  ten  or  fifteen  minutes),  or  use  a 
tight  bandage.  Any  stimulating  liniments,  such  as  camphor,  soap,  or 
arnica,  may  be  used,  but  it  is  questionable  whether  the  good  effects  are 
not  due  more  to  the  massage  than  to  the  drugs  themselves. 

Distortions  of  the  Joint  (Sprains). — By  this  is  meant  a  twisting  or 
temporary  displacement  of  the  joint,  as  a  rule,  in  a  lateral  direction, 
caused  by  slipping  or  sliding,  or  falling  out  of  a  window  and  landing  on 
the  feet,  tumbling  over  the  side  of  a  chair,  bed  or  step.  The  capsule  and 
the  ligaments  may  be  partially  torn  and  in  some  cases  entirely  ruptured 
on  one  side.  The  round  ligament  of  the  hip-joint  is  sometimes  torn, 
as  are  also  the  tendons  of  the  knee-joint;  there  is  extravasation  of  blood 
in  the  injured  region.  "NMth  rest,  the  disease  may  disappear  in  a  few 
days,  or  it  may  remain,  causing  partial  loss  of  power  of  the  legs  for  the 
rest  of  the  animal's  life. 

Clinical  Symptoms. — When  the  sprain  occurs  there  is  violent  pain. 
The  animals  use  the  joint  irregularly,  or  may  carry  the  member.  The 
lameness  increases,  and  in  the  region  of  the  joint  swelling  soon  appears. 
Any  manipulation  of  the  joint  produces  great  i)ain,  and  we  may  be  able  to 
recognize  a  laceration  of  some  of  the  ligaments,  and  the  joint  shows 
greater  mobility  on  one  side  than  the  other.  Where  there  is  tearing 
of  the  broad  ligaments  of  the  hip-joint  there  is  nothing  indicated  l^eyond 
the  lameness  and  symptoms  of  pain  when  the  joint  is  turned  or  twisted. 

Therapeutics. — The  treatment  of  distortions,  or  sprains,  is  the  same 
as  that  for  contusions — compresses  of  cold  water,  lead  water,  lead 
water  and  laudanum,  fuller's  earth  or  antiphlogistine  and  wraj)  up  the 
joint  in  warm  flaimel.  If  the  swelling  is  gnnit,  paint  it  with  tincture 
of  iodine,  and  when  the  swt'Uing  subsides,  use  massaging  and  rul)l)ing 


INJURIES  OF  THE  JOINTS  347 

with  spirits  of  camphor  or  soap  Hniment,  ak-ohol,  etc.,  but  it  must  be 
borne  in  mind  that  rest  is  the  most  important  treatment. 

Luxations  of  the  Joint  (Dislocations). — While  distortions  of  the 
joints  disappear  in  a  short  time  when  the  luxation  is  reduced,  if  it  is  not 
reduced  it  is  lasting,  for  soon  some  anatomical  change  occurs  that  it  is  im- 
possible to  reduce.  If  both  surfaces  of  the  joint  are  no  longer  in  contact, 
it  is  called  an  entire  dislocation.  If  they  are  partially  in  contact,  it  is 
called  an  incomplete  luxation  (subluxation). 

The  causes  of  dislocation  are,  as  a  rule,  mechanical,  from  falling  out 
of  windows,  jumping  from  high  objects,  getting  the  foot  caught,  and 
hanging,  as  in  jumping  over  a  fence;  concussions  and  blows  by  being 
run  over  by  vehicles,  etc.  In  all  dislocations  there  is  invariably  laceration 
of  the  capsular  ligament.  This  membrane  only  remains  intact  in  dis- 
locations of  the  lower  jaw.  As  a  rule,  the  accessory  ligaments  are  seldom 
torn  except  in  such  cases  where  a  portion  of  the  bone  is  torn  with  them. 
The  cartilage  of  the  joint  may  be  torn  or  detached  in  some  cases  by 
the  subsequent  inflammation.  The  ends  of  the  bones  may  be  unaffected 
and  in  some  cases  broken.  Other  alterations  are  seen  in  the  muscles  and 
tendons  in  the  neighborhood  of  the  joint.  They  are  abnormally  ex- 
tended on  one  side  and  flabl^y  on  the  other  side.  They  may  be  torn, 
lacerated,  or  even  crushed.  It  is  only  in  rare  instances  that  the  large 
blood  vessels  and  nerves  are  lacerated.  The  joints  which  are  dislocated 
are  surrounded  by  a  large  quantity  of  blood  which  infiltrates  the  tissues 
and  is  gradually  reabsorbed. 

When  the  reduction  is  not  performed  quickly — that  is  to  say,  the 
displaced  end  of  the  joint  remains  in  its  abnormal  position — we  have 
what  is  called  nearthrosis  as  a  consequence  of  the  irritation  which  it 
produces  in  the  immediate  neighborhood  of  the  joint.  In  such  a  case 
there  is  slight  immobility  due  to  partial  adhesions  of  the  affected  part, 
and  also  due  to  a  certain  extent  to  atrophy  of  the  muscles  surrounding  it. 
In  some  cases  motion  of  the  joint  is  entirely  lost. 

Clinical  Symptoms  and  Prognosis. — When  a  dislocation  has  just 
occurred,  and  Avhen  it  has  been  there  for  some  time,  the  symptoms  are 
more  marked  than  they  are  in  the  intermediate  stage,  for  the  reason 
that  the  hemorrhage  produces  so  much  swelling  as  to  render  obscure, 
to  a  certain  extent,  the  position  and  character  of  the  luxation.  In 
some  cases  the  condition  can  be  very  easily  recognized  by  comparing  it 
with  the  perfect  joint  on  the  other  side;  at  other  times,  it  is  only  by 
careful  manipulation  in  the  region  of  the  joint  that  the  alteration  can  l)e 
felt.  We  may  find  a  projection  of  bone  at  one  place  and  depression  in 
another,  where  they  do  not  occur  in  the  healthy  side.  We  may  even  feel 
the  luxated  end  of  the  joint.  In  some  cases  where  the  deformity  has  been 
concealed  by  the  rapid  swelling  of  the  surrounding  tissues,  the  leg  may 


348  DISEASES  OF  THE  ARTICULATIONS 

he  shorter,  or  it  may  be  on  a  longitudinal  axis  with  the  other  leg.  An- 
other characteristic  symptom  is  the  loss  of  movement  in  the  luxated 
joint,  especially  when  the  case  is  seen  early,  although  in  some  cases 
where  the  ligaments  have  been  lacerated  or  torn,  or  where  a  piece  of 
bone  has  been  broken  off,  there  is  abnormal  flexion  in  that  part.  This 
is  especially  important,  as  it  enables  us  to  locate  a  fracture  of  the  bone 
that  is  in  the  neighborhood  of  the  joint.  There  is  also  a  slight  crepita- 
tion. This,  however,  is  soft,  and  not  the  hard,  rough  crepitation  that 
we  find  in  fractures. 

Luxations  are  not  dangerous  to  life  except  those  of  the  vertebrae, 
but  they  are  very  troublesome,  and,  as  a  rule,  make  slow  recoveries. 
Dislocations  can  be  reduced  quickly  where  the  animal  is  seen  a  short 
time  after  the  injury;  but  in  rare  cases,  on  account  of  the  lacerated 
condition  of  the  capsule  and  ligament,  it  is  rather  difhcult  to  hold  the 
injured  joint  in  position  after  it  has  been  reduced. 

Therapeutic  Treatment. — The  treatment  consists  of:  1.  Reduction 
of  the  dislocation.  2.  In  holding  the  joint  in  position  after  the  reduction 
has  been  made. 

It  is  rather  hard  to  lay  down  any  rule  to  be  followed  in  all  cases, 
but  try  if  possible  to  return  the  joint  to  the  same  position  as  before, 
comparing  it  with  the  joint  of  the  opposite  leg,  following,  as  a  rule, 
the  same  procedure  as  that  followed  in  fractures  of  the  bone.  As  soon 
as  the  reduction  is  made  the  joint  must  he  dressed  and  allowed  to  remain 
if  possible  for  a  period  of  three  weeks  (further  particulars  will  be  found 
in  the  chapter  relating  to  fractures  of  the  bones  and  wounds),  so  that 
the  soft  parts  which  are  lacerated — the  capsule  and  the  ligaments — may 
have  an  opportunity  to  grow  together  and  return  the  joint  to  its  normal 
position.  If  the  dressing  cannot  be  applied  in  cases  of  dislocation  of  the 
hip,  the  animal  must  be  kept  in  a  cage  or  in  a  small  room,  in  order  to 
keep  it  as  quiet  as  possible.  We  may  find  more  or  less  stiffness  of  the 
joint  when  the  dressing  is  removed.  This  can  be  assisted  to  a  certain 
extent  by  means  of  massage. 

The  following  dislocations  appear  more  frequently  in  the  dog  and 
require  special  mention: 

Dislocation  of  the  Lower  Jaw. — This  is  extremely  rare,  and  may 
occur  in  some  instances  where  a  setter  or  retriever  endeavors  to  carry 
a  very  large  bird,  opens  his  mouth,  and  distends  it  in  such  a  way  that  it 
is  dislocated.  In  some  cases  this  luxation  is  confined  to  one  side,  and 
in  others  both  articulations  are  out  of  joint.  The  lower  jaw  projects 
forward,  the  incisors  project  beyond  the  upper  incisors,  giving  the  animal 
an  "undershot"  appearance,  while  in  a  lateral  direction  the  jaw  is  pushed 
to  one  side,  the  mouth  remains  wide  open,  and  cannot  be  closed  except 
with  great  exertion.     In  many  cases,  on  account  of  the  pressure  which  is 


INJURIES  OF  THE  JOINTS  349 

caused  by  the  coronoid  process  pressing  on  the  posterior  portion  of  the 
eye,  it  is  bulged,  causing  what  might  be  termed  an  incomplete  prolapsus 
of  that  organ.  Other  symptoms  are  salivation,  great  pain,  restlessness, 
blue  coloration  of  the  tongue.  (For  differential  diagnosis  of  paralysis 
of  the  lower  jaw,  see  Diseases  of  the  Mouth.) 

Therapeutic  Treatment. — According  to  Stockfleth,  the  animal  must 
be  held  by  an  assistant.  The  best  method  is  to  hold  him  between  the 
legs  and  steady  his  head  while  the  operator  by  means  of  a  lever-like 
action  upon  the  lower  jaw  endeavors  to  reduce  the  dislocation.  To 
accomplish  this,  wrap  a  cloth  around  the  hand,  place  the  thumbs  on 
both  teeth  of  the  lower  jaw,  and  by  means  of  external  pressure  attempt 
to  reduce  the  bone  into  its  normal  condition.  Another  method  which 
the  author  finds  is  not  so  reliable,  consists  in  placing  a  strong  stick 
between  the  jaws,  as  far  back  as  possible,  then  by 
pressure  on  the  anterior  portion  of  the  jaws,  allow- 
ing the  stick  to  act  as  a  fulcrum,  the  jaw  will 
very  often  fly  into  position.  In  order  to  prevent 
a  recurrence  of  this,  the  dog  for  some  time  should 
w^ear  a  particularly  (Fig.  112)  tight-fitting  muz- 
zle and  should  receive  nothing  but  soft  food. 

Dislocation  of  the  Elbow. — In  the  dog  the  bone  of  the  forearm 
forms  a  pivot  joint  with  the  elbow.  Each  of  these  joints  has  a  capsular 
ligament.  The  upper  is  fitted  with  a  ring-like  band,  and  in  the  lower 
portion  the  radius  is  kept  in  position  by  means  of  transverse  ligaments. 
A  slight  rotation  of  the  radius  may  occur  independent  of  the  elbow-joint 
itself.  A  dislocation  of  this  articulation  may  occur  from  jumping 
from  tallies,  chairs,  falling  from  some  height.  In  the  former  case  the 
bone  of  the  forearm  is  dislocated  backward  and  outward.  In  dislocation 
of  the  lower  pivot  joint  the  bone  of  the  forearm  way  project  forward  as 
well  as  backward.  If  dislocation  of  the  upper  joint  occurs  in  the  dog, 
the  forearm  is  kept  flexed;  it  becomes  immobile  in  the  elbow-joint,  the 
animal  using  three  legs  and  carrying  one  in  the  air.  The  joint  is  wider, 
and  the  dislocated  portion  of  the  forearm  may  be  felt  distinctly,  also 
more  or  less  marked  sensitiveness  or  swelling  may  be  seen.  If,  on  the  other 
hand,  we  have  a  certain  amount  of  movement  on  extension  of  the  elbow- 
joint  and  great  elasticity  in  the  joint,  too  much  for  the  normal  condition, 
the  animal  evinces  great  pain  on  movement.  This  dislocation  is  easily 
corrected.  The  joint  may  be  moved  freely,  but  as  soon  as  the  animal 
stands  upon  its  feet  again  the  displacement  occurs.  This  is  due  to  the 
annular  ligament,  which  holds  the  joint  to  the  forearm  in  place,  being 
torn.  If  this  dislocation  is  not  reduced  and  left  for  some  time,  the  leg 
will  be  held  constantly  in  a  flexed  position,  and  the  animal  will  not  use  it. 

In  cases  of  lower  dislocation  of  the  joint  the  animal  walks  upon 


350  DISEASES  OF  THE  ARTICULATIONS 

three  legs,  and  on  examination  we  find  that  the  lower  end  of  the  bone 
of  the  forearm  is  displaced  in  a  posterior  direction,  and  more  rarely  in 
an  anterior  direction.  This  dislocation  is  easily  reduced,  but  on  the 
slightest  movement  reappears  again.  The  prognosis  is  not  favorable, 
as  it  is  a  rather  difficult  condition  to  treat.  The  weak  ligaments  (the 
annular  ligament  and  transverse  ligaments)  do  not  heal  quickly,  and  the 
dislocation  has  a  tendency  to  become  chronic,  especially  in  the  upper 
joint. 

Treatment. — In  the  treatment  of  the  upper  joint  the  forearm 
becomes  extended  and  the  legs  should  be  crossed  and  an  attempt  be 
made  to  push  the  forearm  backward  and  outward  into  its  normal  position. 
It  must  then  be  held  there  by  means  of  a  tight  bandage.  This  bandage 
must  be  changed  once  a  clay,  as  it  is  apt  to  produce  tenderness  of  the 
skin  from  being  so  tight.  If  the  dislocation  affects  the  lower  joint,  the 
bone  of  the  forearm  will  have  to  be  pushed  into  its  normal  condition 
with  more  or  less  force  and  a  silicate  of  sodium  bandage  applied. 

Dislocation  of  the  Patella. — This  is  only  seen  in  small  dogs.  Stock- 
fleth  states  that  the  patella  may  become  dislocated  on  both  sides,  but 
not  upward,  and  that  the  dislocation  is  generally  on  the  inner  side,  on 
account  of  the  forced  extension  of  a  very  much  flexed  tarsus  and  a  ten- 
dency of  the  muscles  to  turn  inward.  This  is  seen  occasionally  in  circus 
dogs  (grayhounds)  making  high  jumps.  In  cases  of  inside  dislocation  the 
patella  lies  on  the  inner  side  of  the  joint  where  it  moves  on  the  tibia,  and 
in  external  dislocation  it  lies  on  the  outside  of  the  external  condyle. 

Inner  Dislocation  of  the  Patella. — In  the  early  stages,  shortly  after 
the  dislocation  occurs,  the  animal  holds  its  leg  in  a  very  flexed  position. 
The  hock  is  flexed  and  the  heel  turned  outward.  At  the  joint  the  jDatella 
may  be  found  lying  sideways,  and  is  easily  moved  laterally.  If  we  take 
hold  of  the  foot  and  flex  or  extend  it,  the  animal  evinces  great  pain.  The 
leg  must  be  bent  backward  and  straightened  as  much  as  possible,  then 
by  means  of  manipulation  of  the  fingers  the  patella  can  be  made  to  slip 
into  position.  This  is  very  easily  performed,  and  the  animal  walks  away 
as  if  nothing  had  occurred.  This  dislocation,  however,  may  recur  when 
the  animal  jumps  any  distance.  When  the  disease  becomes  chronic  and 
dislocation  occurs  often,  the  animal  runs  on  three  legs,  or  walks  lame  on 
the  affected  leg.  The  stifle-joint  is  uneven,  thick,  and  the  patella  can 
be  dislocated,  or  put  into  position  simply  by  pressure  of  the  fingers.  If 
the  dislocation  affects  both  legs,  these  are  kept  in  a  flexed  position, 
the  animal  making  peculiar  jumping  movements,  using  both  legs  at  the 
same  time,  when  he  attemj^ts  to  walk.  If  he  lies  down,  the  hind  legs 
are  extended  backward  and  crossed.  The  prognosis  is  favorable  in  new 
cases,  but  unfavorable  in  old  ones. 

Treatment. — The  tarsus   must  be  extended  in  order  to  overcome 


INJURIES  OF  THE  JOINTS 


351 


the  tension  in  the  straight  ligaments  and  extensors,  and  the  patella  may 
be  easily  shoved  into  position.  If  the  animal  is  then  kept  quiet  for 
several  days,  as  a  rule,  no  after-treatment  is  required.  If  the  disloca- 
tion of  the  patella  is  old,  treatment  is  useless. 

Stockfleth  has  used  a  dressing  in  this  disease  which  he  describes  as 
follows : 

He  attached  a  broad  linen  bandage  around  the  tibia,  and  fastened 
a  wide  girth  around  the  abdomen,  and  a  breast-piece  to  prevent  it  from 
slipping  backward.  The  bandage  w^as  then  fastened  to  the  tibia,  close 
to  the  girth  around  the  abdomen.  The  affected  leg  was  then  pulled  up 
close  to  the  abdomen,  so  that  the  animal  must  stand  on  three  legs.  The 
dressing  remained  on  for  twenty  days,  and  when  it  was  removed  the 


Fig.   113. — Dog  with  dislocation  of  the  hip. 

animal  was  entirely  cured.  In  another  case  he  had  a  double-sided 
dislocation  of  the  knee.  After  returning  the  patellie  to  their  position, 
the  knee-  and  ankle-joint  were  covered  with  thick  wadding,  and  a  capsule 
of  gutta-percha,  which  had  previously  been  soaked  in  hot  water,  was 
applied  to  each  leg,  surrounding  the  leg  from  the  knee  to  the  toes.  In 
order  to  prevent  l^ending  of  the  gutta-percha,  before  it  was  sufficiently 
hardened,  a  wooden  support  was  fastened  to  the  outside.  The  dog, 
which  had  formerly  crept  upon  its  hind  legs,  walked  upright  as  if  on 
stilts.  The  dressing  was  left  on  the  animal  for  two  weeks,  and  on 
removal  of  the  dressing  the  dislocation  did  not  recur. 

External  Dislocation  of  the  Patella.— This  accident  is  very  rare. 
Stockfleth  saw  Init  one  chronic  case  in  both  legs  in  a  small  dog.  The 
subject  was  lively,  walked  rapidly,  but  had  very  flexed  ankle-joints, 
giving  him  very  much  the  appearance  of  a  weasel.  The  tarsus  appeared 
thick  and  uneven;  the  patella,  which  was  located  in  the  muscles  of  the 


352 


DISEASES  OF  THE  ARTICULATIONS 


outside,  could  easily  be  pushed  back  into  its  normal  position;  but  if  left, 
it  immediately  slipped  out  of  position,  and  became  dislocated  again. 
This  was  due  to  the  fact  that  the  crest  of  the  joint  had  disappeared, 
offering  no  resistance  to  dislocation.  Treatment  is  useless,  as  the  tissues 
are  relaxed  and  will  not  hold  the  patella  in  place. 

Dislocation  of  the  Hip. — Other  luxations  occur  in  the  dog — for 
instance,  in  the  hip-joint.  In  this  the  head  of  the  femur  becomes  pushed 
upward  after  laceration  of  the  capsular  ligament,  and  out  of  the  acetab- 
ulum, and  being  drawn  upward  and  by  the  muscular  contraction  the 
leg  is  shortened  (Fig.  113). 

The  animal  must  be  held  by  the  assistant,  keeping  the  body  firm, 
then  grasping  the  leg  at  the  tarsus  and  drawing  it  along  from  the  body 


iM^ 


Fig.  114. — Skiagraph  of  luxation  of  the  hip  upwards  and  backwards. 

downward  and  outward  as  far  as  possible,  and  keep  moving  the  leg 
forward  and  backward;  at  the  same  time,  with  the  other  hand,  seize  the 
trochanter  major  in  the  finger,  or  use  the  flat  of  the  hand,  to  manipulate 
the  joint  into  position.  It  is  impossi])le  to  keep  a  bandage  on  this  part 
unless  it  is  a  pitch  plaster,  which  should  be  applied  and  the  animal  kept 
as  cpiet  as  possible. 

The  joints  of  the  phalanges  sometimes  become  dislocated.  These 
do  not  possess  any  special  symptoms  that  may  not  be  easily  recognized 
by  the  indications  stated  under  Clinical  Symptoms  of  Luxations. 


DISEASES  OF  THE  MUSCLES. 

Muscular  Rheumatism. 

(Muscular  Pains,  Rhcuniatismus  Musculoruw.) 

Muscular  rheumatism  is  a  primary  affection  with  more  or  less 
complication  of  the  muscular  system.  In  some  cases  there  is  little  or  no 
inflammation  present,  no  fever,  and  the  only  indication  of  rheumatism 
being  present  is  stiffness  of  gait  and  pain  on  pressure;  it  may  occur  as 
acute,  subacute,  and  chronic. 

Etiology. — The  cause  of  rheumatism,  which  has  been  described  as 
a  certain  poisonous  substance,  may  also  be  due  to  cold,  atmospheric 
influences,  etc.,  or  dampness,  animals  lying  in  kennels  that  do  not  get 
the  sun,  or  being  kept  in  the  cellar,  particularly  with  asphalt  floors 
hunting  dogs  becoming  wet,  and  after  great  exertion,  sleeping  with  wet 
coats.  We  have,  undoubtedly,  a  number  of  diseases  of  the  muscular 
system  which  do  not  develop  from  rheumatism — for  instance,  abnormal 
muscular  exertion  and  consequent  laceration  of  some  of  the  muscular 
fibres — also  from  disturbances  of  the  circulation,  from  chronic  toxic 
influences,  etc.,  from  some  infectious  agent  as  in  acute  articular  rheuma- 
tism, certain  affections  of  the  spinal  cord,  also  pleuritis,  nephritis  and 
other  affections.  It  would  be  much  better  to  discard  the  name  ''mus- 
cular rheumatism"  and  simply  call  it  "muscular  pain."  Experience 
has  taught  the  writer  that  muscular  rheumatism  is  seen  frequently  in 
old,  delicate,  or  fat  dogs,  and  is  oftener  observed  in  winter  than  in 
summer. 

Pathological  Anatomy. — It  is  very  difficult  to  make  any  definite 
statement  as  to  the  cause  of  rheumatism.  We  speak  of  rheumatic 
muscular  inflammation,  but  at  the  same  time  we  do  not,  as  a  rule,  find 
any  different  muscular  alterations  on  post-mortem  from  animals  which 
have  suffered  from  muscular  rheumatism.  VCe  may  find  slight  altera- 
tions which  have  occurred  from  other  causes,  such  as  hyperaemia,  slight 
exudations  in  the  muscles,  tendons,  and  fascia.  Deposits  occur  in  the 
connective  tissue  (rheumatic  callosities).  These  occur  in  a  man  who 
has  suffered  for  a  long  time  from  muscular  rheumatism,  and  in  old 
rheumatic  dogs  we  may  also  observe  characteristic  alterations  in  acute 
or  chronic  inflammations  and  the'  connective  tissue  between  the  muscular 
fibres  has  increased. 

CUnical  Symptoms  and  Course. — Muscular  pain  is  a  most  marked 
symptom.  This  is  observed  in  slight  cases  by  the  muscles  in  an  affected 
23  353 


354  DISEASES  OF  THE  MUSCLES 

animal  having  a  contracted  appearance,  or  when  by  pressure  upon  them 
they  are  found  hard  and  tense.  We  also  observe  that  dogs  affected  with 
this  disease  move  with  fear,  showing  great  disinclination  for  any  move- 
ment, and  occasionally  they  cry  out  with  pain  when  touched  or  lifted  in 
certain  parts  of  the  body  or  if  any  portion  of  a  particular  muscle  is 
touched.  If  compelled  to  rise,  they  do  so  in  a  slow,  fatigued  way. 
Their  movements  are  stiff  and  strained,  and  when  foeces  are  passed  the 
animals  do  so  with  pain,  frec^uently  crying  or  howling,  or  it  may  be  they 
make  no  effort  to  evacuate  the  bowels,  which  results  in  obstinate 
constipation. 

As  rheumatism  is  generally  located  in  the  regions  of  joints,  these 
symptoms  become  modified  in  certain  parts  of  the  body  and  intensified 
in  others.  We  very  often  see  rheumatism  of  the  back  and  loins,  when 
rising  and  stretching  of  the  extremities  and  all  movements  of  the  trunk 
are  very  painful.  The  region  of  the  back  and  loins  is  very  sensitive,  so 
that  the  animals  cry  at  the  slightest  movement.  The  muscles  in  the 
neck  are  also  subject  to  this  disease  (myalgia  cerviculis,  torticollis 
rheumatica).  Animals  show  great  pain  while  eating  on  account  of 
being  compelled  to  bend  their  neck  in  stooping  down  to  reach  their 
•food.  The  muscles  are  distended  and  painful  to  the  touch.  If  the 
head  is  bent,  the  animal  shoAvs  great  pain.  In  rare  cases  we  see  rheuma- 
tism in  the  masseters  (a  great  difficulty  in  mastication).  Only  in  very 
rare  cases  is  any  fever  noticed. 

The  course  of  the  disease  is  sometimes  acute  and  occasionally 
chronic.  In  the  former  case  the  disease  runs  its  course  very  quickly, 
and  may  disappear  without  any  special  treatment,  but  there  is  always 
a  tendency  to  relapse.  In  the  latter  form  the  disease  may  be  prolonged 
for  months,  varying  in  degrees  of  intensity,  also  showing  a  tendency  for 
the  pain  to  move  from  one  part  of  the  body  to  another,  this  peculiarity 
enables  one  to  readily  distinguish  the  condition  from  one  of  traumatic 
origin. 

Therapeutics. — When  the  disease  is  limited  to  a  certain  group  of 
muscles,  it  is  only  necessary  to  keep  the  animal  in  a  warm  dry  kennel, 
and  feed  with  easily  digested  food  and  rub  the  affected  parts  with 
stimulating  ointments  such  as  oil  of  camphor,  aconite  and  soap  liniment. 
In  rare  instances  the  animal  requires  to  be  muzzled  to  prevent  it  from 
biting  the  affected  part.  Where  the  pains  are  violent,  morphine  should 
be  administered  hypodermically.  As  far  as  the  use  of  electricity 
is  concerned,  the  opinions  concerning  it  are  much  divided.  The 
writer  has  never  been  able  to  obtain  any  very  marked  results  by  using 
this  form  of  treatment.  "N'ibratory  massage,  however,  seems  to  produce 
very  good  results  in  the  milder  and  chronic  cases.  Internally  the  agents 
recommended  for  the  dog  are  salicylic  acid,  salol  or  salipyrin,  aspirin, 


CYSTICERCUS  AND   T RICH IX A  355 

tinctvire  of  colchiciim,  or  antipyrin.     The  first  three  drugs  produce  the 
most  favorable  results. 

In  the  chronic  form  of  the  disease,  various  cutaneous  stimulants 
have  been  used,  such  as  spirit  of  camphor,  opodeldoc,  spirit  of  mustard, 
but  we  must  remember  that  their  influence  is  more  due  to  the  massage 
than  to  anything  else.  It  is  advisable  to  rub  the  stimulating  embroca- 
tion into  the  skin,  either  by  the  hand  or  with  a  woolen  rag.  Albrecht 
has  found  that  this  therapeutic  treatment  may  be  greatly  improved  by 
putting  the  patient  into  a  bath  of  28°,  rubbing  it  dry  and  wrapping  it  in 
hot  blankets. 

Cysticercus  and  Trichina. 

Cysticercus. — Reference  has  already  been  made  to  the  presence  of 
cysticercus  in  the  brain  and  they  also  appear  in  numerous  other  organs, 
particularly  the  muscles,  and  there  is  special  interest  in  the  fact  that 
their  presence  in  large  numbers  in  the  muscles  may  cause  symptoms 
very  similar  to  those  of  muscular  rheumatism.  One  dog  which  was 
very  stiff  during  life  and  kept  the  head  bent  to  one  side  after  death,  in  a 
section  of  the  psoas  muscle  about  an  inch  square  there  were  found  eight 
or  ten  cysticerci  the  size  of  a  pea.  Trasbot  found  in  a  dog  that  during 
life  showed  violent  pain  on  touching  the  skin,  pressing  the  muscles  and 
on  making  certain  movements  of  the  body,  after  death  numerous  cysti- 
cerci of  the  Taenia  solium  in  the  entire  muscular  system.  (For  further 
details  concerning  cysticercus,  see  Internal  Parasites). 

Trichina. — Trichina  is  extremely  rare  in  the  dog.  It  is  observed  more 
in  some  countries  than  in  others.  Of  858  dogs  examined  in  one  clinic,  11 
or  i  per  cent,  were  found  infected  with  trichina.  In  2910  post-mortems 
one-half  of  1  per  cent,  were  found  effected  with  trichina.  The  symp- 
toms which  appear  after  a  dog  has  eaten  meat  containing  trichina 
in  large  numbers  are  for  two  weeks  a  bloody  diarrhoea,  loss  of  appetite, 
pain,  convulsions,  and  after  the  animal  was  destroyed  on  microscopical 
examination  of  the  muscles  they  were  found  to  contain  numerous  mi- 
grating trichina.  Leistikow  fed  three  dogs  with  trichinous  meat  which 
afterward  developed  diarrhoea,  great  exhaustion  and  then  became  normal; 
they  were  killed  six  weeks  later  and  the  flesh  was  found  to  contain 
incapsulated  trichina.  Paroncito  obtained  similar  results  from  feeding 
dogs  with  meat  containing  trichina,  and  two  were  killed  after  a  few  days 
and  the  others  died  in  four  weeks.  In  all  cases  trichina  was  found  in 
the  muscles. 


356 


DISEASES  OF  THE  MUSCLES 


Diseases  of  the  Tendons  and  Bursa  Mucosa. 

Of  the  pathological  processes  of  the  tendons  and  Inirsa  mucosa,  we 
will  onl}'  take  up  the  laceration  of  the  achilles  tendon  and  hygroma. 

Laceration  of  the  Achilles  Tendon. — This  condition  is  occasionally 
met  with  as  a  result  of  violent  exercise  or  injuries  caused  by  falling  out  of  a 
window,  or  having  the  tendon  cut  either  by  jumping  on  glass,  particularly 
on  green-house  sash,  scythes,  reaper  knives,  or  maliciously  cut  by  some 
person,  etc.     Occasionally  it  results  from  the  bites  of  other  dogs,  causing 


r-*' 


Fig.   115. — Laceration  of  the  tendo  achillis. 

wounds  which  are  followed  by  necrosis  of  the  tendon.  On  the  tendon 
being  completely  severed,  the  ends  are  drawn  violently  apart  and  the 
animal  cannot  step  or  put  any  weight  on  the  other  leg  without  putting 
the  posterior  surface  of  the  astragalus  as  well  as  the  whole  of  the  meta- 
tarsus flat  on  the  ground  (Fig.  115).  On  local  examination  we  may  find 
either  an  open  wound  or  the  skin  intact,  but  there  is  a  complete  separation 
in  the  continuity  of  the  tendon.  The  appearance  of  the  animal  is  very 
similar  to  congenital  plantigrade  or  in  cases  of  general  rickets.  The 
articulation  of  the  knee  is  excessively  extended  (Fig.  115). 

Boyer  saw  in  a  mastiff  a  complete  severance  of  the  tendon  just  at 
its  union  with  the  gastrocnemius  muscle.  The  ends  of  the  ruptured 
tendon  were  drawn  apart  al)0ut  5  cm.  In  incomplete  laceration  we 
find  more  or  less  exaggeration  of  the  a.stragulas  and  bending  of  the  knee. 

The  prognosis  is  generally  favorable.  In  case  of  a  wound  with 
severance  of  the  tendon,  the  wound  should  be  thoroughly  disinfected, 


DISEASES  OF  THE  BURSA  MUCOSA 


357 


the  two  ends  should  be  sewed  together  by  means  of  catgut  or  silk,  and 
the  joint  should  be  covered  by  a  splint,  plaster  or  silicate  of  soda,  so  as  to 
hold  it  imniova])le.  "Where  there  is  no  injur}^  to  the  skin,  l)ut  a  rupture 
of  the  tendon,  a  splint  should  be  put  on  and  the  leg  held  in  the  normal 


Fig.  116. — Dog  with  elbow  boil  (hygroma). 

position  for  at  east  two  weeks.  If  this  is  not  successful  the  skin  should 
be  opened  over  the  lacerated  tendon,  the  ends  freshened  by  scarification 
and  united  by  a  stitch.     This  is  generally  successful. 

Hygroma  of  the  Elbow. — Large  heavy  dogs,  particularly  mastiffs, 
St.  Bernards  and  Great  Danes,  have  a  habit,  when  recumbent,  of  lying 
on  the  point  of  the  elbow,  causing  pressure  and  a  gradual  thickening 
and  swelling  of  the  skin  and  frequently  serofibrinous  inflammation  of 
the  bursa  olecrani.  This  is  shown  in  a  round  oval  protuberance  at  the 
elbow,  varying  in  size  from  a  hazel  nut  to  a  goose  egg.  It  is  generally  hot, 
painful  and  frequently  fluctuating  and  contains  a  cpantity  of  serous 
sometimes  serofibrinous  fluid  (Fig.  116).  As  it  is  a  great  eye-sore, 
affecting  the  appearance  of  the  animal  and  at  the  same  time  interfering 
more  or  less  with  the  animal  when  in  a. recumbent  position  it  generahy 
is  emptied  by  making  an  incision  in  a  dependant  part  of  the  serous 
sac,  and  heals  very  rapidly  with  local  treatment.  It  is  very  apt,  however, 
either  to  fill  up  again  as  soon  as  the  opening  closes,  or  to  leave  more  or 
less  thickening  of  the  skin  or  a  hard  fibrinous  mass.  If,  however,  it  fills 
up  again  it  should  be  injected  with  dilute  tincture  of  iodine,  or  Lugol 's 


358  DISEASES  OF  THE  MUSCLES 

.'Isolation.  Sometimes  it  is  necessary  to  open  the  tumor  and  to  curette  the 
inside  of  the  sac  to  get  it  to  heal  properly.  If  the  tumor  still  remains, 
it  should  be  removed  by  complete  extirpation  of  the  enlargement.  The 
operation  is  not  particularl}^  difficult,  the  only  thing  to  contend  against 
is  that  some  animals  by  extreme  flexion  of  the  elbow  are  apt  to  burst  the 
stitches.  The  operator  must  first  shave  off  all  the  hair  in  the  immediate 
region  of  the  tumor,  thoroughly  disinfect  it  and  make  a  long  incision  in 
a  longitudinal  direction  through  the  skin  over  the  body  of  the  tumor, 
taking  care  not  to  penetrate  into  the  body  of  the  tumor.  The  tumor  is 
now  carefully  dissected  out  and  the  inside  of  the  wound  carefully  washed 
with  an  astringent  solution,  such  as  lead  or  zinc,  and  having  cjeaned  out 
the  blood  clots,  the  freshly  cut  surface  should  be  carefully  touched  with 
a  pledget  of  cotton  soaked  in  pure  carbolic  acid;  this  application  tends  to 
lessen  slow  hemorrhage  and  frequently  heals  the  wound  very  quickly. 
The  edges  of  the  opening  are  then  united  by  sutures.  In  dissecting  out 
the  tumor,  care  must  be  taken  not  to  remove  the  periosteum  of  the  ulna. 
A  l^andage  should  l^e  applied  if  possible:  it  is,  however,  very  difficult  to 
hold  it  in  position.  The  animal  should  rest  on  deep  straw  or  some  other 
elastic  material. 


WOUNDS  AND  THEIR  TREATMENT. 


By  a  wound  we  mean  any  injury  which  lacerates  or  punctures  the 
skin,  no  matter  what  is  the  depth.  Wounds  are  chissified  according  to 
various  authors  in  the  following  manner: 

1.  Their  location,  whether  they  are  in  the  head,  neck,  chest,  or 
extremities. 

2.  According  to  their  depth  into  the  muscles  or  l^ones,  they  are 
called  penetrating  or  non-penetrating.  Those  that  injure  the  skin 
slightly  are  called  lacerations  or  excoriations. 

3.  They  are  also  termed  longitudinal,  transverse,  or  oblicjue,  accord- 
ing to  their  direction  or  length.  Regular  or  irregular — that  is,  indented 
or -flap  wounds. 

4.  Their  cause  is  also  considered,  whether  produced  by  cuts,  blows, 
lacerations,  concussions,  bites,  or  gunshot.  These  causes,  however,  are 
of  no  special  importance. 

Clinical  Symptoms. — All  wounds  are  accompanied  by  three  symp- 
toms: the  open,  gaping  condition  of  the  edges  of  the  wound,  hemorrhage, 
and  pain.  As  a  rule,  the  wider  the  wound  the  deeper  it  is.  If  the  wound 
is  long  but  does  not  gape,  it  corresponds  with  the  direction  of  the  muscle  or 
the  tissue  beneath  it.  On  the  other  hand,  wounds  across  muscles  are 
much  wider  and  gape  more,  this  being  due  to  the  retraction  of  the 
muscles. 

The  bleeding  is  either  arterial,  venous,  or  capillary.  The  former  may 
be  recognized  by  the  fact  that  the  blood  from  the  wound  is  mixed  with 
more  or  less  light-colored  arterial  blood.  The  danger  of  such  arterial  bleed- 
ing depends  on  the  size  of  the  arteries  and  how  severely  they  have  been 
injured.  In  small  arteries  the  bleeding  generally  stops  of  its  own  accord, 
due  to  contraction  of  the  severed  blood  vessels;  but  in  large  arteries  the 
animal  will  frequently  bleed  to  death  unless  surgical  interference  stops 
it.  In  cases  where  the  artery  is  cut  in  a  transverse  wound  the  hemorrhage 
is  more  severe  than  when  it  is  in  a  longitudinal  wound.  There  is  more 
bleeding  in  cleanly  cut  wounds  than  there  is  in  those  produced  by  lacera- 
tion or  concussion,  but  the  latter  present  more  complications  than  the 
former,  due  to  consecutive  hemorrhages.  In  venous  bleeding  dark-red, 
evenly  colored  blood  flows  out  of  the  wound.  Hemorrhages  in  small  and 
medium-sized  veins  generally  stop  without  any  surgical  interference, 
but  the  large  veins,  especially  those  in  the  neighborhood  of  the  heart, 
are    dangerous    and   should    ])e   taken   up   cjuickly.     Capillary   bleeding 

359 


300  WOUNDS  AXD  THEIR  TREATMENT 

consists  in  a  slow  tricklino-  of  blood,  which,  as  a  rule,  lasts  for  a  very 
short  time  and  is  of  no  great  importance. 

A  serious  hemorrhage  endangers  the  animal 's  life,  and  the  more 
rapid  it  is  the  greater  the  danger.  The  following  symptoms  are  pre- 
sented: general  coldness  of  the  skin  and  extremities;  paleness  of  the 
mucous  membranes,  especially  the  mouth  and  eye;  great  prostration; 
staggering  gait;  and  often  inability  to  rise  from  weakness.  In  some 
cases  we  have  unconsciousness,  dyspnoea,  enlargement  of  the  pupils, 
uncontrollable  evacuation  of  urine  and  fseces,  finally  slight  convulsions, 
and  death.  This  conclusion  is  to  be  expected  if  about  half  or  even  one- 
third  of  the  blood  contained  in  the  body  is  lost  in  a  very  short  time. 

Many  experiments  have  been  made  upon  the  dog  in  order  to  find 
what  are  the  consequences  of  slight  hemorrhages.  One-fourth  of  a 
dog's  blood  may  be  withdrawn  without  causing  any  appreciable  lessening 
of  the  blood-pressure  in  the  arteries.  The  pulse  may  become  very 
indistinct  while  the  l;)lood  is  withdrawn,  but  it  is  soon  restored  to  its 
ordinary  pressure  if  the  hemorrhage  is  stopped,  from  the  fact  that  the 
arteries  contract  in  proportion  to  the  smaller  quantity  of  blood.  The 
rapidity  of  the  current  and  the  number  of  contractions  of  the  heart 
remain  the  same  as  before  the  hemorrhage.  Any  loss  of  blood  amounting 
to  more  than  one-third  of  the  blood-mass  reduces  the  blood-pressure 
very  much.  The  current  becomes  slow  and  contractions  of  the  heart  are 
much  less.  At  the  same  time  the  composition  of  the  blood  is  changed. 
At  first  we  observe  a  compensation  of  the  water  of  the  blood,  and 
the  salts  which  are  thereby  being  reabsorbed  from  the  tissues  when  this 
is  exhausted;  then  albumin  is  drawn  into  the  blood.  It  requires  a  much 
longer  time  to  form  new  blood  cells  after  the  animal  has  been  bled  an 
amount  of  blood  ec^ual  to  one-fourth  of  the  weight  of  the  body.  The  red 
l)lood  corpuscles  become  normal  and  return  to  their  original  number  in 
from  seven  to  thirty-four  days. 

The  pain  of  a  wound  is  indicated  in  the  dog  liy  howding  and  crying 
when  the  injury  occurs,  or  later  when  the  wound  is  examined.  The  pain 
evinced  by  the  patient  also  depends  upon  the  individuality  of  the  animal. 
Some  dogs  are  great  cowards  and  show  great  sensitiveness  to  the  slightest 
pain,  while  others  will  stand  any  amount  of  it;  and  we  must,  therefore, 
always  carefully  examine  a  wound,  seeing  its  depth,  situation,  and 
character,  and  not  in  any  way  be  guided  in  making  a  diagnosis  by  the 
symptom  of  pain  indicated  by  an  affected  animal.  Wounds  of  the  lips, 
lower  extremities,  external  genitals,  and  of  the  bones  are  the  most 
painful.  In  the  dog  we  see  occasionally  a  series  of  symptoms  which  are 
identical  with  what  is  known  in  man  as  "shock."  This,  as  a  rule,  occurs 
immediately  after  any  painful  injury,  such  as  extensive  crushing  of 
tissues  or  bone,  and  during  or  after  operations.     The  visible  mucous 


DISEASES  FROM  SEPTIC  INFECTION  OF  WOUNDS  301 

membranes  in  the  skin  become  pale,  then  cold;  the  eyes  are  fixed,  the 
pupils  dilated;  the  pulse  becomes  irregular,  reduced  in  volume;  and  the 
respiration  weak  and  irregular.  The  animal  appears  indifferent  or 
unconscious.  These  symptoms  may  disappear  very  rapidly  or  in  some 
cases  go  on  until  the  animal  dies  without  rallying  in  spite  of  any  form 
of  treatment  that  may  be  tried. 

Symptoms  of  a  very  similar  character,  as  a  result  of  extensive 
hemorrhage,  are  sometimes  presented,  and  must  not  be  mistaken  for 
"shock."  The  same  may  be  said  to  occur  occasionally  in  the  dog  when 
under  the  influence  of  chloroform.  It  is  believed  that  the  symptoms  of 
"shock"  presented  are  due  to  an  irritation  or  concussion  of  the  sensitive 
nerves,  producing  reflex  paralysis  of  the  vasomotor  center  of  the  medulla 
oblongata. 


The  Course  of  the  Healing  Process  in  a  Wound. 

The  healing  of  a  wound  depends  to  such  a  large  extent  on  its  form, 
condition,  location,  and  treatment,  that  from  a  practical  standpoint  we 
may  generally  separate  the  processes  into,  first  intention,  or  healing  by 
primar}'  union;  second,  healing  by  second  intention  or  suppuration; 
third,  healing  under  a  dry  scab;  fourth,  healing  under  a  moist  scab;  the 
various  processes  of  wound  healing  can  be  studied  in  works  on  surgery. 

Diseases  Resulting  from  Septic  Infection  of  Wounds. 

There  are  a  number  of  conditions  which  appear  in  wounds  that  are 
due  to  microbes  or  germs,  producing  certain  irritations  of  the  tissues 
surrounding  the  wounds,  especially  the  blood  vessels  and  the  lymphatics. 

Phlegmon. — By  this  we  mean  the  inflammation  of  the  soft  tissues 
which  has  a  tendency  to  formation  of  pus,  especially  in  the  loose  sub- 
cutaneous connective  tissue  between  the  muscles  and  under  the  fasciae. 
There  are  two  forms  of  this  condition — a  circumscribed  and  a  diffused 
phlegmon. 

Circumscribed  Phlegmon. — The  symptoms  are  very  prominent, 
especially  Avhen  it  is  near  the  skin.  We  find  in  a  certain  circumscribed 
region  a  hot,  painful,  very  red  swelling,  firm  and  tense  in  the  early  stages, 
but  soon  becoming  soft,  doughy,  and  finally  fluctuating,  due  to  the  tissue 
breaking  up  and  forming  a  purulent  licjuid.  From  the  pressure  of  the 
pus  the  skin  becomes  gradually  thinner  and  thinner,  until  the  pus  finally 
makes  its  exit  through  the  skin  and  escapes.  If,  for  some  reason,  the 
skin  is  too  tough,  or  if  the  pus  has  not  been  allowed  to  escape  by  means 
of  an  incision,  it  may  cause  a  purulent  infiltration  of  the  surrounding 
tissues,  which  is  very  serious  and  ends  with  necrosis  of  the  parts,  espe- 


3G2  WOUNDS  AXD  THEIR  TREATMENT 

{■[ally  of  the  fasciee,  tendons,  muscles  and  bones,  and  it  may  be  taken  up  in 
the  blood,  and  portions  of  the  diseased  tissues  are  carried  in  the  circula- 
tion to  different  parts  of  the  body. 

Diffuse  phlegmon  is  generally  a  very  serious  condition.  The  local 
symptoms  are  the  same  as  the  circumscribed,  but  the  fever  is  much 
higher,  and  the  purulent  pus  rapidly  extends  in  all  directions  in  the 
loose  connective  tissue,  undermining  and  frequently  causing  extensive 
necrosis  of  the  skin,  fasciae,  muscles,  tendons,  etc.  Death  occurs,  as  a 
rule,  from  septicamiia  or  pyaemia. 

The  treatment  of  diffused  phlegmon  consists  of  scarification  and 
incisions.  Numerous  slight  incisions  are  made  to  reduce  the  inflamma- 
tory tension  of  the  tissues  and  to  encourage  the  pus  to  escape,  also  to 
prevent  it  from  burrowing  in  different  directions,  and  to  make  an  opening 
into  the  parts  so  that  they  can  be  disinfected  by  means  of  injections  or 
irrigations  of  1  to  1000  solution  of  corrosive  sublimate,  3  to  5  per  cent, 
of  carbolic  acid,  or  2  per  cent,  of  creolin.  In  circumscribed  phlegmon 
it  is  better,  as  a  rule,  to  wait  until  the  abscess  is  in  that  condition  known 
as  "ripe,"  or  until  it"  points."  This  can  be  distinguished  from  the  fact 
that  the  swelling  fluctuates  or  is  soft  in  the  centre.  In  a  light  skin  it  may 
be  even  yellow.  As  soon  as  the  incision  is  made  it  should  be  emptied  and 
irrigated  and  injected  with  an  antiseptic  solution,  afterward  treated  as 
an  ordinary  wound. 

Inflammation  of  the  Lymphatics  {Lymphangitis). — This  is  caused 
by  poison  absorbed  from  an  unclean,  unhealthy  wound,  although  in 
some  instances  it  may  be  caused  by  a  high  nitrogenous  condition  of  the 
blood  due  to  overfeeding.  The  author  has  observed  several  cases  in 
dogs  where  one  or  more  of  the  legs  was  hot,  painful,  and  swollen,  and 
there  were  also  lameness  and  an  increase  of  temperature.  On  examining 
the  subcutaneous  lymphatics  they  were  found  to  be  enlarged,  presenting  a 
peculiar  corded  appearance  and  running  in  the  direction  of  certain  of 
the  lymphatics.  These  were  enlarged  and  very  tender  to  the  touch. 
In  cases  of  this  kind  we  may  see  two  terminations:  first,  a  rapid  recovery; 
second,  the  formation  of  an  abscess  containing  a  large  amount  of  purulent 
pus  in  the  swollen  lymphatic  glands,  producing  extensive  inflammation, 
blood-poisoning,  and  the  animal  eventually  dying  from  septicaemia. 

The  therapeutic  treatment  consists  first  in  the  iri'igation  of  the  parts 
with  cooling  applications,  and,  if  the  glands  show  indications  of  forming 
abscesses,  apply  hot  poultices  and  open  as  soon  as  possible. 

Inflammation  of  the  Walls  of  the  Blood  Vessels  (Phlebitis). — This  is 
especially  interesting  to  the  veterinarian,  as  it  is  quite  frequently  seen  in 
the  dog.  Purulent  inflammations  of  the  blood  vessels  are  seen  in  con- 
nection with  infectious  purulent  wounds,  and  originate  as  a  secondary 
symptom  by  extension  of  the  suppurating  process  from  the  surrounding 


DISEASES  FROM  SEPTIC  INFECTION  OF  WOUNDS  363 

tissues.  This  is  especially  noticeable  where  the  wall  of  the  vessel  is 
crushed,  forming  a  thrombus,  and  this  thrombus,  lying  in  the  IjIoocI  vessel, 
becoming  infected  from  the  wound,  produces  suppuration  and  breaks 
down,  and  is  carried  into  the  general  circulation  and  deposited  in  some 
part  or  organ  of  the  body,  setting  up  an  irritation,  and  a  consequent 
formation  of  an  abscess.     This  condition  is  termed  "metastatic  abscess." 

The  therapeutics  are  the  same  as  those  of  lymphangitis.  Open 
the  wound  as  soon  as  possil)le  and  thoroughl}'  disinfect  the  abscess. 

Fever. — Concerning  the  clinical  symptoms  of  fever,  we  have  giA^en 
all  necessar}'  details  on  page  9.  The  fever  which  accompanies  wounds 
varies  greatly  in  intensity  according  to  the  cause.  The  following  are 
the  different  varieties  of  wound  fever: 

1.  Aseptic  Wound  Fever. — This  is  produced  by  entrance  into  the 
circulation  of  the  blood  of  harmless  substances  (water,  irrigating  fluids, 
non-decomposed  wound  secretions,  and  fibrinous  ferments).  This 
occurs  in  the  majority  of  cases  shorti}'  after  the  animal  receives  the 
wound,  and  causes  very  slight  disorder  in  the  general  condition.  The 
rise  of  temperature  is  generally  the  only  visible  symptom  in  the  dog. 
There  is  no  alteration  in  the  appetite,  and  the  temperature  is  reduced 
within  a  few  hours;  in  very  rare  cases  it  may  be  slightly  increased  for 
two  or  even  three  days. 

2.  Septic  Wound  Fever  and  Septicaemia. — As  soon  as  putrid  or 
decayed  sul)stances  find  their  way  into  the  system  by  means  of  a  wound 
the  symptoms  of  fever  appear  rapidly.  If  they  are  mild  in  character, 
it  is  called  "septic  wound  fever;"  if  they  are  acute,  presenting  symptoms 
which  may  endanger  the  life  of  the  animal,  it  is  called  "septicaemia." 
Septic  wound  fever  and  septicaemia  are  only  separated  by  their  degree  of 
intensity,  otherwise  they  are  similar.  There  is  one  difference  that  we 
will  point  out  between  septic  poisoning  and  septic  infection,  and  that  is, 
in  the  first  form,  the  micro-organisms  which  produce  putrefaction  are  to 
be  found  only  in  the  centre  of  infection  and  not  in  the  blood,  while  in  the 
second  form  the  centre  of  infection  is  in  the  blood  and  in  the  tissues. 

Septicaemia  appears,  as  a  rule,  thirty-six  to  forty-eight  hours  after 
the  injury  with  an  increase  of  temperature  as  high  as  40.5°,  rarely  above, 
and  showing  a  remittent  character  marked  by  depression,  fatigue,  and 
loss  of  appetite,  the  last  being  very  rare.  If  the  wound  is  treated  quickly 
and  rendered  thoroughly  antiseptic,  the  symptoms  rapidly  disappear. 
The  most  dangerous  forms  of  septicaemia  which  occur  most  frequently  in 
the  dog  ajDpear  two  to  four  days  after  the  injury,  showing  a  general  disturb- 
ance of  the  system,  and  frequently  without  presenting  any  unusual 
symptoms  in  the  wound  itself.  The  temperature  is  rarely  increased  to 
any  extent.  Move  often  it  is  normal  or  subnormal.  "We  are  not  able,  there- 
fore, to  place  any  dependence  on  the  temperature  as  far  as  prognosis 


304  WOUXDS  AXD  THEIR  TREATMENT 

is  concerned,  the  onh'  value  being  when  the  normal  temperature  is  pre- 
sented and  the  acute  symptoms  already  described  begin  to  abate. 

We  sometimes  see  very  peculiar  cases — for  instance,  the  author  has 
observed  a  case  of  septicaemia  with  normal  temperature  the  first  day 
accompanied  by  weakness,  depression,  loss  of  appetite,  etc.  In  the  next 
few  days  the  temperature  gradually  increases;  sleepiness,  fatigue,  and 
rapid  emaciation;  the  symptoms  increase  in  intensity;  the  pulse  becomes 
weak,  rapid,  and  much  slower,  until  it  falls  below  the  normal  rate,  and 
finally  ends  in  the  death  of  the  animal.  In  many  cases  diarrhoea  is 
present,  and  in  rare  cases  convulsions. 

Therapeutics. — Antiseptic  solutions  must  be  used  vigorously  and 
the  wound  irrigated  frequently.  If  there  is  any  dead  tissue  that  is  hard 
to  loosen,  the  thermo-cautery  should  be  used  to  render  it  aseptic.  The 
animal  must  be  stimulated  by  means  of  ether,  alcohol,  and  camphor. 
The  writer  finds  subcutaneous  injections  (4.0  to  6.0  doses)  of  spirit  of 
camphor  or  camphorated  ether,  1  to  10,  of  great  value  in  such  cases. 
This  drug  he  is  inclined  to  call  a  specific  agent  in  septicaemia.  It  must 
be  injected  every  two  or  three  hours  under  the  skin  until  the  alarming 
symptoms  have  disappeared.  Slight  muscular  contractions  which 
sometimes  follow  the  use  of  camphor  are  not  to  be  regarded  as  anything 
especially  serious. 

3.  Purulent  Fever  and  Pyaemia. — When  a  suppurating  wound 
becomes  very  much  inflamed  and  infects  the  surrounding  tissues,  it  is 
generally  followed  by  the  entrance  into  the  blood  of  some  microorganisms. 
If  the  symptoms  of  fever  are  slight,  the  patients  may  recover,  wdth  only 
a  chill  and  a  slight  increase  of  temperature.  If  the  fever  is  very  serious 
and  the  temperature  rises  high,  it  is  called  pyaemia.  In  this  disease  you 
will  find  that  the  majority  of  cases  are  follow^ed  by  metastatic  suppura- 
tion in  various  organs  of  the  body.  This  is  due  to  the  fact  that  the  throm- 
bus undergoes  purulent  destruction  in  the  blood  vessels,  breaks  down, 
and  the  infectious  matter  is  carried  into  the  circulation,  and  from  there 
it  fintls  its  way  to  different  organs  or  locations  in  the  liody.  The  symp- 
toms of  pyaemia  in  the  dog  are  not  very  easily  distinguished  from  those 
of  septicaemia,  and  it  is  very  hard  in  the  majority  of  cases  to  make  a 
positive  diagnosis.  Very  frequently  we  see  symptoms  of  septicaemia 
and  pyaemia  combined,  forming  what  is  known  as  septico-pyaemia.  In 
this  case  the  animal  dies  before  any  deposit  of  the  suppurating  poison 
has  produced  abscesses.  In  pyaemia  the  symptoms  are  marked  by  chills 
in  the  early  stages,  and  by  intermittent  fever.  The  appetite  is  often 
good,  and,  as  a  rule,  rarely  cntii'ely  absent,  as  in  septicaemia.  Later  the 
disease  presents  much  more  serious  symptoms:  the  fever  loses  its  inter- 
mittent character,  the  temperature  remaining  high;  the  appetite  disap- 
pears; fatigue  and  weakness  may  occur;  the  patients  become  rapidly 


DISEASES  FROM  SEPTIC  INFECTION  OF  WOUNDS  305 

emaciated  and  finally  die.  AVith  these  symptoms  we  see  metastatic 
suppuration  in  the  internal  organs. 

The  therapeutic  treatment  of  pysemia  is  similar  to  that  of  septicaemia. 

Treatment  of  Wounds. — In  the  treatment  of  wounds  we  must  pursue 
the  following  directions  to  obtain  good  results:  1.  That  the  edges  of  the 
wound  must  be  brought  together  as  soon  as  possible  to  encourage  union. 
2.  That  in  the  treatment  of  wounds  we  must  protect  them  from  all  kinds 
of  irritation,  and  especially  from  the  invasion  of  micro-organisms. 

A  wound  may  be  infected  with  microl:)es  through  the  hair,  or  by 
direct  infection  from  unclean  hands,  instruments,  dressing  materials, 
or  septic  fluids.  It  is  also  possible  to  infect  a  wound  from  the  blood. 
The  main  point  in  the  treatment  of  wounds  should  be  to  prevent  the 
direct  entrance  of  microbes  into  it,  or  to  destroy  the  infectious  substances 
which  have  entered  the  wound,  and  finally  to  put  it  in  such  a  condition 
as  to  prevent  the  fui'ther  development  of  any  microbes  that  may  still 
remain  there.  The  first  is  rather  difficult  in  the  dog  even  under  ordinary 
circumstances;  the  last  can  be  followed  out  to  a  certain  extent,  as  the 
treatment  of  wounds  is  greatlyinfluenced  in  the  dog  by  two  facts :  first,  many 
dogs  will  not  allow  a  dressing  to  remain  in  place;  and,  second,  a  wound  is 
interfered  with  to  a  certain  extent  by  the  tendency  that  all  dogs  have  to 
lick  the  injured  part.  For  this  reason  we  frequently  have  to  modify  the 
treatment  of  wounds  in  the  dog.  We  must,  however,  apply  a  dressing 
in  all  cases  where  we  can  keep  the  patient  quiet  and  prevent  him  from 
removing  it.  The  veterinarian  has  t^^■o  powerful  agents  at  his  disposal 
for  the  treatment  of  wounds:  the  first  is,  primary  disinfection  of  the 
wound  and  its  neighborhood;  second,  keeping  the  wound  as  dry  as  possible. 

1.  The  First  Disinfection  of  Wounds. — This  is  of  special  importance, 
and  especially  during  and  after  operations  where  there  is  much  blood  lost. 
The  wound  and  everything  coming  in  contact  witli  it,  also  the  tissues 
surrounding  it,  should  be  carefully  rendered  antiseptic.  The  hair  has  to 
be  shaved  or  cut  very  close,  the  skin  washed  with  ether  or  benzine  in 
order  to  remove  all  the  fatty  matter  lying  in  the  skin.  Follow  this  by 
washing  with  antiseptic  fluids  (1  per  cent,  solution  of  sublimate,  3  per 
cent,  carbolic  acid,  2  per  cent,  crcolin).  Any  existing  wound  has  to  be 
treated  in  the  same  manner.  If  there  is  a  wound  the  shape  of  which 
forms  a  cavity,  an  antiseptic  solution  must  be  injected  into  it  and  come 
in  contact  with  all  parts.  The  irrigator  shown  in  Fig.  117  is  especially 
adapted  to  that  purpose.  For  cleansing  wounds  do  not  use  sponges 
unless  they  are  thoroughly  aseptic,  also  disinfect  the  gauze  and  dressings 
(tampons).  Instruments  and  the  operator's  hands  must  also  be  care- 
fully attended  to.  The  former  should  be  placed  in  an  antiseptic  solution 
of  carbolic  acid,  5  per  cent.,  or  a  2  per  cent,  solution  of  creolin.  Do  not 
use  corrosive  sublimate  solution  for  instruments,  as  it  leaves  an  insoluble 


366 


WOUNDS  AXD  THEIR  TREATMENT 


coating  of  mercury  on  the  steel.  The  hands  and  nails  have  to  be  brushed 
and  washed  with  carbolic  solution,  or  sublimate  soap.  During  the 
operation  the  wound  should  be  disinfected  from  time  to  time — that  is  to 
say,  it  should  be  washed  or  wiped  with  the  solutions  referred  to  above. 
2.  Future  Treatment  of  the  Wound. — This  consists  of  various 
measures,  according  to  whether  there  is  hemorrhage  and  the  condition 
of  the  wound. 

Stopping  all  Hemorrhage. — If  the  blood  which  runs  into  a  wound  is 
left  there,  it  has  a  bad  effect,  preventing  an  adhesion  of  the  surfaces  of 
the  wound,  and  also  being  a  favorable   ground   for 
the  development  of  microbes. 

Drainage  of  the  Wound. — By  this  we  mean  the 
removal  of  wound  secretions,  especially  pus,  by 
means  of  drainage-tubes.  The  regular  drainage- 
tubes  are  made  of  rubber,  having  numerous  holes 
cut  in  them.  These  are  placed  in  the  deepest  part 
of  the  wound,  and  fastened  by  means  of  a  stitch 
in  the  skin,  or  the  wound  closed  around  it.  In 
small  wounds,  instead  of  the  rubber  tube  we  use 
small  pieces  of  silk  thread  or  catgut  which  have  been 
twisted  together  in  the  shape  of  a  cord.  In  wounds 
which  are  not  deep,  but  cavernous,  and  where  it  is 
difficult  to  get  ciuick  adhesion  in  order  to  insure  pro- 
per drainage,  it  is  best  to  leave  the  wound  open, 
covered  with  antiseptic  powder,  such  as  sulphonal, 
boric  acid,  naphthalin,  salicylic  acid,  etc.  The  first- 
named  agents  possess  special  properties  for  the 
treatment  of  surgical  wounds,  drying  them  rapidly 
and  depriving  the  microbes  of  a  proper  medium  to 
develop  in,  and  thus  rendering  it  impossible  for  in- 
fection to  extend. 

It  is  advisable  to  use  some  material  that  wall  take  up  the  secretions 
of  the  wound  c{uickly,  and  assist  in  drying  them.  For  this  purpose,  we 
cover  the  wound  with  salicylic-  or  carbolic-acid  or  corrosive  sul)limate 
gauze.  In  a  wound  where  there  is  a  deep  cavity,  it  is  well  to  fill  it  for 
twenty-four  to  forty-eight  hours  after  the  operation  with  a  tampon  of 
sublimate  gauze,  then,  having  removed  the  gauze,  clean  the  wound  and 
by  means  of  sutures  bring  it  together  and  cover  it  with  antiseptic  gauze. 
The  following  is  the  ordinary  treatment  of  wounds: 
I.  Controlling  the  Hemorrhage. — This  may  be  accomplished  in  various 
ways.  The  best  method  is  by  means  of  a  ligature.  As  a  rule,  this  is 
performed  by  carefully  ligating  the  bleeding  blood  vessel,  either  directly 
on  the  vein  or  artery,  or  taking  up  a  certain  portion  of  the  tissue  wdth  a 


Fig.  117. — .\pparatus 
for  the  antiseptic  irriga- 
tion of  wounds. 


DISEASES  FROM  SEPTIC  INFECTION  OF  WOUNDS 


367 


pair  of  forceps,  including  the  blood  vessels,  and  tying  it  behind  the 
point  of  the  instrument  with  a  ligature.  When  the  bleeding  end  of  a 
blood  vessel  is  located  in  very  firm  tissue,  out  of  which  it  cannot  be 
drawn  far  enough  to  ligate,  we  pick  up  the  blood  vessel  with  the  end  of 
the  forceps,  draw  it  out  as  far  as  possible,  and  twist  it  in  a  spiral  direction; 
by  this  means  we  usually  succeed  in  controlling  the  hemorrhage.  If, 
however,  the  above  does  not  answer,  we  pass  a  thread  through  the 
tissue  underneath  the  blood  vessel  and  tie  it  tightly,  and  by  this  means 
close  the  opening. 

Compression  is  sometimes  used  as  a  means  of  stopping  hemorrhage. 
This  we  can  accomplish  by  pressure  of  the  finger  above  the  bleeding 
region,  or,  if  it  is  an  extremity,  ligate  the  member  above  the  part  by 


Fig.  118.— Different  forms  of  stitches  used  in  the  dog  and  method  of  tying:  a,  head-stitch;  6, 
cjntinuous  oblique  stitch  with  cross-stitch;  c,  deep  continuous  cross  stitch;  d,  mattress-stitch;  e,  but- 
ton and  interrupted  stitch. 

means  of  a  rubber  band  or  tube,  or  even  a  handkerchief.  Another  means 
of  stopping  a  hemorrhage  is  by  using  a  cauterizing  iron  (thermo-cautery). 
These,  however,  should  only  be  used  in  wounds  where  you  do  not  expect 
healing  by  first  intention.  All  agents  which  have  the  property  of  stopping 
hemorrhages,  as  a  rule,  coagulate  or  draw  the  tissues  in  such  a  way  as  to 
prevent  healing  by  first  intention. 

Capillary  or  slight  subcutaneous  hemorrhages  can  be  stopped  by 
pressure  or  irrigation  with  cold  water.  Hot  water  is  also  sometimes  used 
to  control  hemorrhage. 


368  WOUNDS  AND  THEIR  TREATMENT 

Wounds  which  can  heal  by  first  intention,  such  as  all  operative 
wounds  which  have  been  thoroughly  disinfected  according  to  the  method 
described  above,  and  where  the  hemorrhage  has  been  stopped,  we 
bring  together  by  stitches  or  ligatures  (Fig.  118).  As  a  rule,  the 
ordinary  knot-stitch  with  antiseptic  silk  is  used,  although  we  may  con- 
nect it  with  other  forms,  such  as  the  extension  stitch  (Fig.  1 18).  Small 
wounds  do  not,  as  a  rule,  reciuire  drains.  The  wound  should  be  com- 
pressed for  several  minutes  by  means  of  an  antiseptic  sponge,  and  after 
that  covered  with  collodion.  If  the  position  of  the  wound  allows,  we 
must  apply  a  firm,  compact  dressing  over  every  wound  that  is  stitched; 
if  it  is  a  simple  one,  the  dressing  may  remain  until  it  is  entirely  healed — • 
that  is,  for  about  one  week.  If  we  have  a  large  wound,  however,  with 
flaps,  caverns,  etc.,  it  is  advisable  to  place  drains  in  the  wound  and 
change  the  dressing  after  three  or  four  days.  Instead  of  collodion  dress- 
ing in  such  wounds,  use  antiseptic  powders,  such  as  sulphonal,  der- 
matol,  bismuth  subnitrate  and  boric  acid.  These  should  be  dusted  on 
the  wound  itself,  directly  on  the  line  of  the  severed  skin. 

The  writer  has  been  in  the  habit  of  covering  ordinary  sewed  wounds 
with  a  thin  layer  of  antiseptic  gauze,  and  covering  over  that  a  dry, 
antiseptic  muslin  bandage,  and  finally  over  these  two  covers  a  damp 
starched  gauze  bandage.  The  latter  has  the  advantage  of  forming  a 
stiff  envelope,  becoming  dry  on  account  of  its  starchy  contents,  and 
exerting  a  certain  hold  on  the  injured  member.  If  a  serious  rise  in 
temperature  takes  place,  the  dressing  must  be  immediately  removed  and 
the  directions  followed  which  are  given  under  the  head  of  "Wound 
Fever."  When  the  bandage  has  been  displaced, 
and  when  it  has  been  moistened  by  the  wound 
secretion,  it  must  also  be  changed. 

Wounds  which  heal  under  a  dry  scab  are  gen- 
erally  superficial.      These   do  not   require  to  be 
closed  by  means  of  stitches,  and  they  seldom  are 
119.—.  uzzc.  hcked  or  irritated   by   animals.     In  these  cases 

we  use  the  following  method  of  treatment. 

After  thoroughly  disinfecting  the  wound  and  its  neighborhood  with 
some  antiseptic  solution — dilute  corrosive  sublimate  or  creolin  solution — 
allow  it  to  dry,  and  b}^  means  of  a  camel's  hair  brush  paint  the  irritated 
dermis.  We  produce  an  artificial  scab,  or  we  cover  the  wound  surface 
with  collodion.  The  latter  is  recommended  in  common  lacerations.  As 
a  rule,  no  dressing  is  used.  The  scab  loosens  after  some  time  and  falls 
off.  When  we  are  obliged  under  certain  circumstances  to  leave  a  wound 
open  it  is  advisable  to  muzzle  the  animal  (Fig.  119),  not  only  to  prevent 
the  patient  from  licking  the  wound,  l)ut  in  order  to  properly  apply  a 
sprinkling  powder,  and  get  good  results  from  it.     The  best  powder  to 


DISEASES  FROM  SEPTIC  INFECTION  OF  WOUNDS  369 

use  is  boric-creolin  (1  part  of  ci-eolin  to  40  or  50  parts  of  boric  acid), 
naphthalin  or  sulphonal  (1  part  to  5  parts  of  starch),  dermatol,  airol, 
aristol,  bismuth  subnitrate  or  zinc  oxide.  An  open  wound  generally 
recpires  antiseptic  washings  daily.  It  frequently  happens  that  granu- 
lating wounds,  especially  when  they  have  been  subjected  to  exposure  to 
air  or  are  constantly  irritated  by  the  animal,  may  at  some  period  lose 
their  power  of  healing  and  become  converted  into  ulcers. 

Ulcers  or  Ulcerations. — By  this  we  understand  a  granulating  surface 
which  does  not  heal  on  account  of  the  purulent  destruction  of  the  granular 
tissue.  Wounds  are  changed  into  ulcers  when  they  are  continually 
irritated  by  some  mechanical  or  chemical  irritant,  or  as  a  consecjuence  of 
the  skin  becoming  inflamed  or  necrosed  from  pressure  (muzzling,  etc.). 
Callous  ulcers  and  fistulous  ulcers  are  the  most  difficult  to  treat.  The 
former  are  superficial  ulcers  with  hard,  callous  centre,  having  raised 
edges,  and  a  whitish,  hard,  bacon-like  surface.  This  is  covered  with  a 
thin  unhealthy  secretion.  They  may  form  sinuses  or  canals,  which  very 
often  contain,  at  the  bottom  of  the  sinus,  a  foreign  body  or  necrosed 
tissue.  They  may  also  lead  to  some  of  the  glands.  These  pipes  are 
called  fistulse  or  fistular  canals. 

The  treatment  of  ulcers  is,  to  a  certain  extent,  the  same  as  that  of 
wounds — that  is,  to  follow  all  the  antiseptic  rules.  The  use  of  dermatol, 
airol,  aristol,  subnitrate  of  bismuth,  salicylic  acid,  naphthalin,  powdered 
camphor,  or  boric-acid  ointment  is  advisable.  We  may  also  remove 
callous  ulcers  by  surgical  means  and  convert  them  into  fresh  wounds  by 
taking  a  knife,  paring  the  tissue  at  the  bottom  of  the  ulcers,  and  treat 
them  as  indicated  in  cases  of  fresh  wounds.  Caustic  agents  produce 
little  or  no  good  effects.  If  the  tissue  surrounding  the  ulcers  is  hard  and 
rigid,  preventing  contraction  of  the  ulcerated  area  and  the  healing 
process,  we  must  perform  circumcision  of  the  part,  as  transplantation 
is  not  practicable  in  the  dog.  We  cut  about  1  cm.  from  the  border  of  the 
ulcer  over  its  entire  thickness,  keeping  the  wound  open  by  means  of 
vaselin.  When  we  treat  a  fistulous  canal  and  the  location  of  the  fistulous 
sinus  admits  of  it,  we  split  open  the  fistulous  passage  and  convert  it  into 
an  open  wound.  When  the  fistulous  canal  is  not  very  deep  we  may  also 
try  to  produce  healthy  granulations  by  means  of  actual  cautery,  or  the 
injection  of  caustic  fluids  or  the  introduction  of  crayons  of  caustic 
(nitrate  of  silver  or  caustic  potash).  Always  try  to  slit  open  the  canal, 
if  possible,  as  it  produces  the  best  effects.  Nitrate  of  silver  or  any  of 
the  mineral  acids,  and  in  obstinate  cases  a  small  piece  of  corrosive  sub- 
limate, is  pushed  down  into  the  bottom  of  the  wound;  these  caustics 
produce  more  or  less  irritation  and  consequent  sloughing  of  the  wall  of 
the  canal  and  allow  the  growth  of  healthy  granulations. 

Contusions. — In  subcutaneous  wounds  of  the  soft  tissues  (bruises 
24 


370  WOUNDS  AXD  THEIR  TREATMENT 

and  contusions)  we  find  a  different  condition  of  the  tissues.  These 
injuries  are  generally  caused  by  some  blunt  object — for  instance,  a  blow, 
kick,  shock,  or  fall.  The  soft  parts  are  bruised  and  injured  according 
to  the  intensity  of  traumatism;  very  slight  resistance  is  offered  by  the 
loose  connective  tissue;  small  blood  vessels  are  ruptured  from  crushing 
or  bruising  the  soft  parts,  and  the  hemorrhage  that  follows  percolates  all 
through  the  torn  tissues.  The  greatest  amount  of  resistance  is  found  in 
the  skin,  face,  sinews,  and  large  blood  vessels. 

Clinical  Symptoms  of  Contusions. — One  of  the  first  symptoms  of 
a  subcutaneous  bruise  is  a  swelling  in  the  region  of  the  injury.  This 
appears,  as  a  rule,  immediately  after  the  injury,  and  is  due  to  the  blood 
running  out  of  the  torn  vessels.  The  fluids  in  the  enlargement  always 
contain  lymphatic  substances  on  account  of  the  laceration  of  certain 
lymphatic  glands.  In  rare  cases  Ave  see  a  lymphatic  secretion  only, 
which  is  distinguished  from  the  blood  secretion  by  being  very  slowly 
absorbed.  The  fluid  which  appears  lies  either  in.  the  loose  connective 
tissue  under  the  skin  or  between  the  muscles,  and,  as  a  rule,  is  irregularly 
divided,  or  we  may  find  the  condition  presented  in  a  number  of  ways; 
for  instance-  we  may  find  a  ''doughy"  swelling  in  one  case,  or  it  is  accu- 
mulated in  centres  in  another,  or  we  see  a  fluctuating  swelling  or  a 
"blood  boil"  (hematoma),  or  it  may  run  into  a  cavity,  and  we  have  a 
bloody  secretion  of  the  joint  (hemarthrosis) ,  or  we  find  a  bloody  secre- 
tion in  the  cavity  of  the  chest  (hematothorax).  The  swellings,  as  a  rule, 
occur  shortly  after  a  contusion,  and  in  the  early  stages  rarely  show  any 
inflammatory  symptoms.  Later,  however,  inflammatory  symptoms 
may  appear. 

Beside  the  swollen  condition  of  the  tissues,  the  animal  may  present 
symptoms  of  pain,  especially  at  the  time  of  the  injury,  and  later  on  we 
find  the  injured  region  very  tender  to  the  touch. 

The  further  course  of  the  wound  depends  to  a  great  extent  on  the 
amount  of  the  injury.  If  the  skin  is  crushed  in  such  a  manner  that  all 
the  vessels  are  torn,  it  will  become  necrosed  from  deficient  nutrition,  and, 
as  a  result,  is  indicated  in  the  discharge,  which  contains  septic  blood  and 
broken  doAvn  tissue. 

In  the  treatment  of  contusions,  to  get  good  results  we  must  have  one 
object  in  mind — that  is,  the  rapid  reabsorption  of  the  secretion.  For 
that  purpose  we  use  cooling  compresses  soaked  in  lead-water  (Goulard 's 
extract),  or  arnica-water,  or  we  may  try  to  get  absorption  by  means  of 
massage — that  is  to  say,  make  a  centrifugal  friction  with  the  thumbs, 
fingers,  or  hand  for  fifteen  or  twenty  minutes  at  a  time.  We  may  also 
squeeze  the  excreted  blood  into  the  tissues  and  lymphatic  passages,  and 
apply  a  tight  bandage  immediately  afterward  to  prevent  any  recurrence 
of    the    subcutaneous    bleeding.     This    latter    treatment   is   not   to   be 


DISEASES  FROM  SEPTIC  INFECTION  OF  WOUNDS  371 

practised  unless  the  swelling  is  very  small  and  there  is  very  little  fluid 
in  it. 

The  therapeutic  treatment  is  not  simple  in  all  contusions.  In  large 
"fluid-boils"  we  rarely  can  wait  for  an  absorption  of  the  secretion,  Init 
are  compelled  to  open  the  swelling  at  the  point  where  it  is  soft  and  where 
the  skin  is  thinnest.  In  animals  we  must  always  try  to  make  an  opening 
in  the  dependent  part  of  the  enlargement,  so  as  to  get  perfect  drainage. 
After  having  opened  the  tumor,  clean  it  out,  removing  all  clots,  etc.,  and 
treat  the  inner  surface  of  the  wound  according  to  the  usual  method, 
applied  in  such  cases.  If  the  location  of  the  wound  prevents  such  a  pro- 
cedure, the  fluid  may  be  emptied  by  means  of  a  hypodermic  syringe,  and 
an  antiseptic  solution  injected  in  its  place,  and,  if  possible,  this  should 
be  followed  up  afterward  by  a  compress-dressing. 

In  all  cases  where  the  skin  is  very  much  injured,  or  w^here  extensive 
destruction  of  the  soft  parts  has  taken  place,  or  even  fracture  of  the  bone 
has  occurred,  we  cannot  use  massage,  but  instead  compressing  antiseptic 
dressings  must  be  applied.  As  a  rule,  treat  the  slightest  injuries  of  the 
skin  according  to  the  l:)est  antiseptic  methods. 

Inflammatory  symptoms  are  observed  as  soon  as  fever  appears. 
The  skin  becomes  hot  and  painful;  finally  fluctuation  is  found  in  some 
parts.  Then  we  must  immediately  remove  the  secretion,  clean  out  the 
wound,  and  by  drainage  keep  the  cavity  empty,  at  the  same  time  inject 
into  the  wound  a  1  to  1000  solution  of  corrosive  sublimate  or  a  5  per  cent, 
solution  of  car])olic  acid,  and  use  an  antiseptic  bandage. 

Bums  and  Scalds. — In  cases  where  a  high  degree  of  temperature  acts 
on  the  skin  it  causes  hypersemia  in  milder  cases,  to  necrosis  and  sloughing 
in  severe  cases.  For  convenience  of  descriptions,  we  divide  burns  into 
three  classes  or  degrees.  The  first  degree  of  burning  is  indicated  by 
great  pain,  redness  and  swelling  of  the  skin;  the  second  degree  causes 
violent  serous  exudation  in  the  stratum  mucosa  and  is  indicated  by  the 
formation  of  blisters  containing  a  yellowish  serous  fluid  which  dries  or 
may  bui*st  the  vesicle  when  it  is  followed  by  more  or  less  suppuration. 
Burns  of  the  third  degree  are  indicated  by  more  or  less  extensive  necroses 
of  the  skin.  The  necrosed  portion  of  flesh  forms  a  scab  which  is  separated 
from  the  surrounding  healthy  tissue  by  a  demarcating  line  of  granulating 
tissue.  Extensive  burns  may  cause  death  in  a  few  hours.  In  such  cases 
the  animal  shows  violent  pain,  is  greatly  excited  and  restless,  the  pulse 
is  very  high,  hard  and  wiry.  The  respirations  are  increased,  subnormal 
temperature  and  death  follows  in  a  short  time.  Sometimes  there  is  violent 
vomiting,  followed  by  convulsions;  the  prognosis  depends  on  the  severity 
of  the  burns  or  scalds.  Very  frequently  a  scalded  animal  is  disfigured 
for  life  as  a  result  of  the  extensive  destruction  and  subsequent  necrosis 
of  the  epidermis,  which  destroys  the  han-  bulbs  and   prevents  future 


372  WOUNDS  AXD  THEIR  TREATMENT 

growth  of  hair.  Treatment  in  all  cases  consists  in  applying  cooling 
applications  that  prevent  the  air  from  reaching  the  burned  surface, 
such  as  flour,  starch,  boracic  acid,  or  talcum  powder,  applications  of  solu- 
tions of  lead  water,  acetate  of  alum  or  cresol,  or  unction  of  petrolatum, 
zinc  or  lead  oxide  ointments,  also  ointments  of  ichthyol  or  thigenol  (1  to 
10),  lead  liniment  1  part  of  acetate  of  lead  and  10  parts  of  olive  oil, 
calcium  liniment  (so-called  carron  oil),  lime  water  and  linseed  oil  equal 
parts,  or  mixture  of  equal  parts  of  carron  oil  and  carbolized  oil  (1  to  20) 
or  a  mixture  of  a  beaten  up  egg  and  linseed  oil.  Blisters  of  very  large 
size  should  be  opened  with  a  fine  needle,  taking  care  to  make  a  very  small 
opening  in  the  covering  of  the  blister  and  endeavor  to  prevent  it  from  being 
rubbed  off.  In  case  the  epidermis — that  is  to  say,  the  covering  of  the 
blister — is  rubbed  off,  the  above-mentioned  salves  and  liniments  can  be 
used,  but  drying  powders  such  as  dermatol,  airol,  aristol,  subnitrate  of 
bismuth,  oxide  of  zinc  are  much  to  be  preferred.  These  drugs  are 
generally  rubbed  up  with  starch  or  talcum  and  dusted  on  the  sore  by 
means  of  a  pledget  of  absorbent  cotton,  a  perforated  tin  dusting  box  or 
blown  on  by  means  of  an  insufflator.  Powders  of  salicylic  acid  or 
magnesia  in  combination  with  talcum  powder  should  be  employed  where 
there  is  suppuration  or  scalding  of  the  third  degree.  Some  recommend 
a  solution  of  picric  acid  1  to  100,  or  a  5  per  cent,  solution  of  nitrate  of 
silver.  Where  the  animal  is  in  very  violent  pain,  we  should  use  cocaine 
in  solution  as  a  local  application.  A  bandage  of  absorbent  cotton  is 
put  over  the  scalded  portion.  This  is  rather  difficult,  however,  to  keep 
in  position,  as  in  cases  of  severe  scalding  the  animal  constantly  moves 
or  twists  the  body  in  endeavoring  to  lick  or  bite  the  wounds.  This  must 
be  prevented  if  possible.  In  cases  of  acute  or  extensive  scalds  the  animal 
must  be  covered  with  cotton  batting  and  given  some  of  the  various 
stimulants  such  as  alcohol,  camphor,  or  ether,  and  also  the  subcutaneous 
solution  of  common  salt  is  to  be  recommended. 

Frost  Bites. — Freezing  is  comparatively  rare,  prol^ably  due  to  a 
certain  extent  to  the  fact  that  frost  bites,  if  they  happen  to  be  mild  in 
character,  are  either  overlooked  or  mistaken  for  other  affections.  Frost 
bites  occur  in  hunting  dogs,  in  the  work  dogs  of  Europe,  and  also  the  sled 
dogs  of  Canada  and  Alaska.  Freezing  generally  appears  in  the  feet. 
Muller  and  Frick  found  freezing  to  be  rather  common  in  hunting  dogs, 
but,  except  when  it  is  more  or  less  extensive,  is  not  observed  by  the 
attendants  of  the  animal.  Schneidermuhl  observed  a  bitch  that  had  a 
frozen  udder.  Schindelka  saw  one  case  where  a  clog  had  his  ear  frozen. 
As  in  burning,  we  divide  freezing  into  three  degrees  depending  on  the 
severity  of  the  symptoms.  In  freezing  of  the  first  degree  we  find 
in  the  frozen  portion  slight  dark  red  or  blue  colored  swellings.  In 
freezing  of   the  second  degree,  there  appear  a  number  of   bladders  or 


DISEASES  FROM  SEPTIC  INFECTION  OF  WOUNDS  373 

blisters,  containing  yellow  hemorrhagic  serum,  and  after  the  vesicles 
burst  there  is  more  or  less  loss  of  tissue  and  the  wound  heals  very  slowly 
leaving  a  very  pronounced  cicatrix.  Freezing  of  the  third  degree  is 
accompanied  by  more  of  less  gangrenous  mortification  of  the  frozen  portion. 
Chilblains  (perniones)  are  seen  occasionally  in  dogs  that  are  kept 
chained  in  yards  and  pointers  that  hunt  in  the  snow  or  over  frozen 
ground.  The  treatment  of  frost  bites  of  the  first  degree  consists  in 
attempting  to  remove  the  venous  stasis  by  means  of  friction  or  a  liniment, 
such  as  spirits  of  camphor  or  aconite  or  paint  the  affected  portion  with 
tincture  of  iodine.  The  application  of  moist,  warm  compresses  is  also 
beneficial.  For  freezing  of  the  second  degree,  in  which  blisters  have 
been  formed,  apply  drying  powders  already  mentioned  and  if  gangrene  has 
commenced,  the  wound  must  be  treated  with  antiseptics.  Where  the 
animal  is  completely  frozen,  as  is  indicated  by  the  rigidity  of  the  body, 
avoid  warming  the  animal  too  quickly.  The  animal  must  first  be  rubbed 
with  a  cloth  which  has  been  dipped  in  cold  water  or  given  a  bath  in  cold 
water  and  gradually  the  heat  of  the  water  increased  up  to  the  bodily 
temperature;  at  the  same  time  the  body  is  to  be  rubbed  constantly. 
Subcutaneous  or  intervenous  injections  may  be  administered,  such  as 
ether  or  camphor.     Artificial  respiration  may  also  be  resorted  to. 

Snake  Bites. — In  Europe  there  are  three  species  of  venomous  snakes 
which  may  bite  dogs.  They  are  the  common  viper  (vipera  berus),  the 
asp  (vipera  aspis  radii)  and  the  sand  viper  (vipera  ammodytes).  The  first 
serpent  is  found  all  over  Europe,  the  asp  in  Switzerland,  the  sand  viper 
in  Dalmatia.  ■  In  America  we  find  the  rattlesnake  (crotalus)  and  the 
copperhead  (trigonocephalus  contort  rix)  and  moccasin  (toxicophis 
piscivorus)  and  puff  adder.  The  poison  of  the  snake  lies  in  two  glands 
which  lie  at  the  base  of  the  long  teeth.  Sporting  dogs  and  shepherd  dogs 
are  generally  bitten  on  the  legs  and  sometimes  on  the  mouth.  A  short 
time  after  the  animal  is  bitten,  we  find  about  the  bitten  portion  a  bluish- 
red  tumefaction  which  is  extremely  painful  and  has  a  doughy-like  feel  to 
the  finger.  The  pulse  is  small  and  thready,  the  respirations  frequent. 
The  animal  attempts  to  vomit  and  finally  may  become  totally  paralyzed. 
As  a  rule  the  animal  makes  a  good  recovery  and  it  is  only  in  rare  instances 
that  it  results  fatall3^  The  treatment  consists  in  putting  a  tight  ligature 
immediately  al)ove  the  affected  portion  and  this  must  be  left  on  until 
the  effects  of  the  poison  have  passed  off.  Subcutaneous  injections  of  spirits 
or  ammonia  diluted  with  three  parts  of  water.  The  following  drugs  are 
also  recommended  to  be  applied  directly  to  the  wound:  calcium  chlorate, 
chloral  water,  tincture  of  iodine,  hydrate  of  potassium  or  nitrate  of  silver. 
The  thermocautery  can  also  be  used.  It  is  to  be  understood  that  any 
of  the  preparations  to  be  of  any  service,  must  be  used  immediately  after 
the    animal    has    been    bitten.     Karlinski    recommends    subcutaneous 


374  WOUXDS  AXD  THEIR  TREATMENT 

injections  of  solution  of  cliromie  acid  (1  to  100).  Lacerda  advises  sub- 
cutaneous injections  of  pei-manganate  of  potash  (1  to  GO).  Where  the 
animal  exhibits  great  weakness,  we  should  administer  alcoholic  stimu- 
lants— Ijrandy,  whiskey,  or  sherry — and  to  these  add  a  few  drops  of  spirits 
of  ammonia.  Ether,  camphor,  atropia  are  all  advised  as  stimulants. 
A  serum  has  been  prepared  to  combat  the  effects  of  a  snake  bite. 

Wounds  of  the  Tip  of  the  Tail. — Wounds  or  injuries  to  the  tip  of  the 
tail  are  generally  found  in  short-haired  dogs  with  long  tails,  particularly 
great  danes,  pointers,  and  beagles.  Wounds  of  this  character  are  caused 
l\v  the  dog  shaking  the  tail  and  hitting  against  solid  objects,  particularly 
where  dogs  are  kept  in  narrow  kennels  and  wag  their  tails  and  strike  the 
sides  of  the  kennel.  It  is  a  peculiar  fact  that  while  injury  of  the  tip  of  the 
tail  is  insignificant,  it  is  one  of  the  most  difficult  to  treat  and  cure.  This 
is  caused  by  several  facts;  first  dirt  and  scabs  collect  on  the  wound  which 
causes  the  animal  to  constantly  lick  and  gnaw  the  sore.  Another  fact 
i':;  an  animal  will  keep  gnawing  at  the  tail  when  there  is  apparently  no 
reason  for  it.  The  tail  seems  sometimes  to  be  intensely  itchy,  due  prob- 
ably either  to  neuritis  or  to  itching  eruptions  of  the  skin.  The  animal 
gnaws  and  bites  the  tail  as  if  in  a  fury  of  pain  or  irritation  until  the  vertebra 
is  exposed  causing  necrosis  of  the  bone  and  slough  of  portions  of  the  tissue 
or  even  one  or  two  bones  of  the  coccyx.  Sometimes  we  find  certain  ecze- 
matous  eruptions  that  extend  from  the  back  and  root  of  the  tail  along  the 
entire  body  of  the  tail,  and  the  animal  is  constantly  licking  and  biting  it. 

The  first  line  of  treatment  is  to  endeavor  to  lessen  the  irritation  and 
to  heal  the  sore.  First  clean  the  tail  carefully  and  thoroughly  with  warm 
Avater  and  soap  and  remove  all  dirt,  scabs,  etc.,  from  the  injured  or 
irritated  portions,  and  after  drying  the  tail,  dust  on  antiseptic  powders 
such  as  boracic  acid,  airol,  dermatol  or  tannoform  or  even  paint  the 
injured  portion  with  collodion  or  compound  tincture  of  benzoin.  Where 
there  is  an  ulcerated  portion  of  the  skin,  it  should  be  stimulated  with  a 
stick  of'  nitrate  of  silver  or  in  cases  where  there  is  deep  ulceration  it  may 
be  necessary  to  touch  the  affected  portions  with  the  thermocautery. 
After  applying  the  antiseptic  dusting  powder  it  is  necessary  to  apply  a 
bandage  on  the  tail  and  for  this  purpose  there  is  nothing  better  than  a 
bandage  held  in  place  with  carpenter's  glue.  This  is  applied  in  the  fol- 
lowing way:  Strips  of  muslin  or  linen  are  covered  with  glue  (ordinary 
glue  that  is  warmed  slightly  to  render  it  more  liquid)  then  the  affected 
portions  are  covered  with  tlie  antiseptic  dusting  powder  and  a  small 
portion  of  absorbent  cotton  filled  with  the  powder  is  applied.  The 
strip  of  muslin  covered  with  the  glue  is  laid  on  lateral  sides  of  the  tail 
from  the  root  of  the  tail  around  the  tip  and  back  and  the  glue-covered 
side  directly  on  the  hair  (Fig.  120).  Another  strip  may  be  put  on,  cover- 
ing the  superior  and  inferior  surfaces  of  the  tail,  then  strips  are  wound 


DISEASES  FROM  SEPTIC  INFECTION  OF  WOUNDS 


375 


around  the  tail  to  hold  on  these  strips,  either  at  the  root  and  tip,  as  shown 
in  Fig.  120,  or  along  the  entire  tail  as  shown  in  Fig.  120.  Care  should 
be  taken  not  to  wind  the  circular  strips  too  tight  as  the  bandage  is  apt  to 
contract  c^uite  consideral)ly  when  the  glue  dries.  The  bandage  sticks 
closely  to  the  hair  and  has  many  advantages  over  adhesive  plaster.  It 
is  impo8sil:)le  for  the  animal  to  shake  it  off,  and  if  he  should  show  an 
inclination  to  gnaw  at  it  a  muzzle  should  be  put  on  the  animal.  The 
bandage  should  be  changed  every  five  or  six  days.  The  bandage  is 
removed  by  putting  the  tail  in  warm  water  or  covering  the  bandage  with 


Fig.  120. — Bandage  for  injuries  or  amputation  of  the  tail. 

a  cloth  saturated  with  warm  water  and  allowing  it  to  remain  for  ten 
minutes,  when  the  strips  are  easily  taken  off;  the  tail  washed,  dressed 
and  another  bandage  "applied,  taking  the  precaution  to  have  the  tail  dry 
before  re-applying  the  glue  bandage.  A  leather  cone  for  the  protection 
of  the  tail,  called  a  "tail-muzzle,"  generally  causes  great  irritation  and  the 
animal  is  in  a  constant  state  of  irritation  while  it  is  on  and  is  constantly 
trying  to  get  it  off. 

Amputation  of  the  Tail. — The  necessity  of  amputation  of  a  portion 
of  the  tail  may  not  only  originate  from  the  causes  already  enumerated 
but  from  the  tail  being  run  over  by  a  wagon  wheel,  from  being  caught 


37G  WOUNDS  AND  THEIR  TREATMENT 

between  swinging  doors,  or  being  tramped  on.  It  may  also  be  caused 
from  fracture  of  the  tail  or  from  malformations.  Occasionally  it  may 
be  the  seat  of  a  diffuse  swelling  as  a  result  of  phlegmons  or  from  septi- 
caemia from  the  wound  of  the  end  of  the  tail  becoming  infected.  In  such 
cases,  however,  it  is  best  to  make  a  series  of  longitudinal  incisions  in  the 
tail  where  the  swelling  is  greatest  and  allow  the  serum  to  escape  and  at 
the  same  time  give  an  energetic  course  of  antiseptic  applications  and 
if  these  measures  do  not  succeed,  then  we  have  to  resort  to  amputation. 
Amputation  of  the  tail  is  also  performed  in  pointers  to  shorten  the  tail 
and  prevent  them  from  getting  the  tail  sore  going  through  brush  and 
lacerating  the  end.  And  lastly  certain  breeds  of  dogs  have  their  tails 
amputated  when  young  as  a  matter  of  fashion. 

When  local  applications  do  not  have  the  desired  effect  and  the  tail 


Fig.  121. — Amputation  of  the  tail  (circular  operation). 

becomes  gradually  worse  or  the  vertebra  becomes  necrosed  the  only 
means  left  is  to  amputate  the  affected  part. 

The  operation  is  a  form  of  exarticulation.  An  amputation  between 
two  of  the  vertebrae  is  much  better  than  cutting  through  one  of  the  bones. 
The  operator  must  distinguish  the  slightly  enlarged  portion  (Fig.  121) 
where  the  articulation  lies.  Put  the  animal  under  ether  or  give  a  hypo- 
dermic injection  of  morphine  or  a  subcutaneous  one  of  cocaine;  have  tied 
an  elastic  band  around  the  tail  above  the  point  of  operation,  then  proceed 
by  means  of  the  flap  or  round  operation,  whichever  is  preferred.  As  the 
vessels  bleed  slightly  they  can  easily  be  stopped  by  means  of  a  thermo- 
cautery. The  circular  operation,  cutting  posterior  to  the  bony  pro- 
tuberances of  the  articulation;  pull  the  skin  back,  cutting  through  the 
muscles  and  tendons  just  below  the  articulation;  then,  with  the  help  of 
an  assistant,  pull  up  the  tissues  and  cut  between  the  cartilaginous  discs. 
Then  bandage  the  tail  as  shown  in  Fig.  120.  In  cases  in  older  dogs 
where  there  is  much  hemorrhage  the  artery  may  be  taken  up  by  means 
of  a  catgut  ligature  or  touched  with  the  thermo-cautery.     The  edges  of 


DISEASES  FROM  SEPTIC  INFECTION  OF  WOUNDS  377 

the  skin  are  united  l)y  interrupted  suture  and  an  antiseptic  dressing  is 
applied,  talving  care  not  to  make  it  too  tight.  The  flap  operation  is  the 
same  as  has  ah-eady  been  described. 

The  operation  of  cutting  puppies'  tails  in  fox  terriers,  spaniels, 
poodles,  is  best  done  just  before  the  puppies  are  weaned.  When,  after 
judging  the  proper  length  the  tail  is  to  be,  in  proportion  to  that  of  the 
body,  the  tail  should  be  cut  through  with  a  sharp  knife.  It  is  not  neces- 
sary at  that  age  to  attempt  to  cut  exactly  through  the  articulation. 


DISEASES  OF  THE  CLAWS  AND  FOOT  PADS. 


The  claws,  the  third  phalanx,  of  the  toe  (the  bone  of  the  claw) 
articulates  with  the  second  phalanx;  near  the  articulatory  surface  is  an 
annular  fold  (claw  fold)  which  receives  the  free  border  of  the  claw. 
The  phalanx  tertia  is  covered  by  the  cutis  vera.  This  develops  and 
grows  from  the  matrix  of  the  claw  plate  (coronet),  the  claw  bed,  and  the 
muscular  sole  which  is  an  extension  of  the  corium  which  extends  over 
the  third  phalanx  after  dipping  into  the  circular  furrow  at  the  base  of 
the  bone  (Fig.  1 22) .     In  order  to  protect  the  ends  of  the  claws  when  not 


Fig.  122. — Nail.  Longitudinal  section  of 
nail.  «,  Matrix  of  nail  horn;  a',  papillary 
zone  of  nail  horn:  b,  bed  of  na^l;  c,  mnt'ix 
of  cushion;  d,  cushion;  e,  nail.  (.Siedain- 
grotzlcy.) 


Fig.  123. — Diagram  of  the  first  and 
second  phalanx.  a,  Tubercle  of  pad; 
b,  horn  groove;  c,  groove  of  sole;  d, 
third  phalanx;  e,  dorsal  ligament. 
(Siedamgrotzky.) 


in  use  there  is  an  elastic  tendinous  band  which  draws  back  the  nail  and 
when  the  foot  is  on  the  ground  the  nail  is  retracted  (Fig.  123)  and  the 
v/eight  of  the  body  carried  on  the  pads,  those  pillow-like  elastic  bodies,  a 
large  one  in  the  centre  and  four  radiating  in  front  of  it,  corresponding  to 
each  toe,  the  thumb  toe  being  too  high  up,  does  not  get  pressure  (Fig.  124). 

Ingrowing  Claws.  Incarnatio  Unguis. — Animals  that  are  house  pets 
and  have  little  or  no  exercise  do  not  wear  the  nails  properly  and  they 
become  long  and  are  apt  to  strike  the  ground  when  walking.  Occasion- 
ally these  nails  l)ecome  so  long  as  to  turn  under  and  the  weight  of  the 
animal  presses  the  claw  into  the  pad  and  the  claw  is  gradually  buried  in 
the  flesh.  The  dew  or  spur  claws  on  the  posterior  extremities  frequently 
grow  entirely  round  and  grow  into  the  pad,  causing  great  irritation, 
swelling  and  suppuration.  It  is  extremely  painful,  the  animal  constantly 
licking  the  affected  pai't.  It  can  be  cut  through  by  a  pair  of  jeweler's 
wire  clippers,  care  being  taken  not  to  cut  it  too  close  and  involve  the 
matrix. 

Splintei'ing,  cracking  and  breaking  of  the  claws  are  generally  due  to 
some  traumatism,  although  occasionally  the  claw  falls  off  from  purulent 

378 


DISEASES  OF  THE  CLAWS  AND  FOOT  PADS 


379 


Fig,  124.— Pads  of  foot. 
a,  Carpal  pad:  b,  .sole;  c, 
1  to  5,  toe  pads. 


inflammation  of  the  matrix.     The  broken  ends  of  the  claws  must  be  filed 

or  pared  down  to  make  the  surface  smooth  and  prevent  it  catching  in 

carpets,  rugs,  etc.,  and  tearing  it  further.     Occasionally  a  dog  with  long 

crescent-like  nails,  due  to  want  of  wear,  catches  it  in  a  carpet  or  rough 

boards  in  a  floor  when  he  is  running  and  the  claw  is 

torn  loose  from  the  matrix,  hanging  l^y  a  small  piece 

of  very  sensitive  flesh,  and  every  time  the   animal 

moves  or  it  touches   an   object,   it    causes    extreme 

pain.     As  it  is  generally  hanging  by  a  small  portion 

of  flesh  it  can  be  seized  by  the  fingers  and  quickly 

torn  off,  or  if  it  is  more  firmly  fixed,  it  can  be  cut  off 

by  means  of  a  pair  of  small  wire  cutters,  care  being 

taken  not  to  cut  too  close  to  the  matrix. 

Where  there  is  extensive  injury  to  the  matrix, 
it  may  be  necessary  to  exarticulate  the  part. 

Where  the  nail  is  torn  from  the  matrix  and  that 
is  exposed,  it  is  not  advisable  to  bandage  it.  Paint 
it  once  daily  Avith  compound  tincture  of  benzoin. 

Inflamed  Claw.  Panaritium. — This  may  origin- 
ate from  traumatisms,  such  as  being  stepped  on, 
crushed  between  doors,  or  the  extension  of  inflam- 
matory process  from  the  leg,  from  unknown  causes 

which  develop  an  inflammation  of  the  matrix  of  the  claw,  and  is 
also  seen  in  dogs  that  are  very  highly  fed  and  are  plethoric. 
There  frequently  appears  a  gouty  inflammation  of  the  second  phalanx 
and  the  matrix,  causing  considerable  congestion,  pus  and  sloughing  of 
the  nail.  Eczematous  eruption  of  the  local  epidermis  is  also  com- 
mon in  overfed  dogs;  the  two  conditions  are  apt  to  recur  in 
these  plethoric  dogs  from  time  to  time.  In  rare  cases  pus  is  found 
and  may  burrow  under  the  tissues,  causing  fistula  or  after  the 
acute  inflammation  subsides,  a  thickening  of  the  toe.  Occasionally  one 
toe  is  attacked  and  when  the  acute  symptoms  sulxside,  then  another  is 
attacked;  it  has  been  thought  to  be  contagious,  but  this  condition  is  so 
frequently  seen  in  overfed  animals  that  it  evidently  is  gouty  in  character. 
Frick  found  that  salt  water  produced  irritation  of  the  claws  in  animals 
that  were  at  seashore  places  during  the  autumn  and  winter.  Ral:)e 
ascribes  this  condition  to  a  microbe  which  he  calls  Cladothrix  canis. 

In  acute  inflammation  of  the  claw  the  animal  is  very  lame  and  on 
examination  of  the  toe  it  is  found  hot,  swollen  and  very  tender  to  the 
touch;  the  skin  surrounding  the  affected  toe  is  tumefied  and  congested; 
the  claw  is  very  painful;  the  animal  gives  evidence  of  acute  agony  if  it  is 
touched;  the  claw  is  dull,  the  natural  lustre  having  entirely  disappeared, 
and  frequently  the  claw  may  have  changed  its  position,  that  is,  it  may 


380 


DISEASES  OF  THE  CLAWS  AND  FOOT  PADS 


curl  under  or  turn  to  one  side;  in  one  case  observed  the  claw  was  flattened 
like  the  nail  of  a  man. 

Treatment. — Fomentations  and  poultices,  painting  the  affected  toes 
with  tincture  of  iodine.  It  generally  is  best  to  repeat  this  application 
two  or  three  times.  If  the  claw  is  purulent,  it  must  be  treated  with  an 
antiseptic  dressing  of  corrosive  sublimate,  1  to  2000  solution;  when  the 
claw  is  loose,  it  must  be  removed,  taking  care  not  to  injure  the  matrix 


Fig.  125. — Dog's  shoes:  Laced  leather  shoe  showing  shape  of  sole,  and  rubber  shoe. 

or  the  skin  at  the  edge  of  the  nail  and  destroy  the  secreting  power  of 
the  claw.  Frick  has  prevented  the  further  extension  of  the  disease  by 
intraparenchymatous  injections  of  tincture  of  iodine,  the  internal 
administration  of  Fowler's  solution,  and  touching  the  affected  claw  with 
nitrate  of  silver.  The  nail  can  be  protected  by  means  of  the  shoe  illus- 
trated in  Fig.  125. 

Contusions  and  Wounds  of  Pads. — Contusions  of  the  pads  are  most 
frequently  ol:)served  in  sporting  dogs,  particularly  in  animals  that  have 
not  been  used  for  active  work  or  when  they  are  first  trained,  going  over 
stubble  fields,  or  in  dogs  going  over  long  distances  on  snow  or  frozen  roads. 
Occasionally  we  find  extensive  oedema  and  sloughing  caused  by  the 
presence  of  an  clastic  band  placed  around  the  foot  or  toes  by  a  child  in 
play. 

The  animals  walk  very  stiff,  or  in  some  cases  it  may  be  almost 
impossible  to  get  them  to  walk.  The  pads  are  hot  and  painful  on 
pressure;  if  the  pad  is  very  much  worn  the  dark  external  skin  is  worn  off 
antl  the  red  tissue  shows  on  the  surface;  in  cases  of  extreme  wear  there 


ABDOMINAL  HERNIA  381 

is  suppuration  and  sloughing  of  the  pad.  Occasionally  foreign  liodies, 
nails,  glass,  stones,  tacks,  splinters  of  brass  wire,  etc.,  stepping  in  acids, 
particularly  when  emptying  electrical  batteries,  or  stepping  in  fresh 
slacked  lime.  In  the  latter  case  the  external  portion  of  the  pad  is  fre- 
quently entirely  sloughed  of!". 

Treatment. — In  simple  contusions  rest  is  all  that  is  needed;  in  more 
severe  conditions,  paint  the  pad  several  times  daily  with  compound  tincture 
of  benzoin,  or  use  compresses  of  sugar  of  lead  water  or  acetate  of  alum. 
"When  the  skin  is  separated,  clean  it  with  an  antiseptic  wash  and  remove 
the  loose  portion  of  tissue  and  cover  it  with  tincture  of  benzoin  and  apply 
a  compress.  In  the  first  examination  of  an  animal  in  this  condition  it 
is  always  necessary  to  make  a  careful  examination  of  the  part  to  see  if 
there  are  any  foreign  bodies  buried  in  the  pads.  When  the  soles  are 
very  tender  the  shoe  shown  in  Fig.  125  is  very  useful.  Sole  protectors 
are  also  made  of  chamois  leather. 

HERNIAL  RUPTURE. 

Abdominal  Hernia. 

By  the  word  ''hernia"  we  understand  a  protrusion  of  a  certain 
portion  of  the  abdominal  contents  through  a  normal  or  abnormal  open- 
ing in  its  walls,  and  where  the  displaced  portion  is  covered,  or  partially 
covered,  by  the  peritoneum.  In  the  majority  of  cases  hernia  appears 
under  the  external  skin,  although  we  may  find  it  in  other  parts,  such  as 
hernia  of  the  diaphragm.     There  are  several  different  forms  of  hernia. 

We  distinguish  the  following  parts  in  a  hernia:  first,  the  intestines 
or  contents  which  protrude  from  the  abdominal  cavity;  second,  the 
hernial  pouch;  third,  the  envelope,  or  covering  of  the  rupture;  and, 
fourth,  the  entrance  or  constricted  portion  of  the  rupture,  or  where  the 
intestine  passes  through  the  abdominal  wall.  By  "hernial  pouch"  we 
mean  that  part  of  the  peritoneum  which  is  around  the  part  protruding 
from  the  abdominal  cavity,  and  we  distinguish  it  where  it  is  near  the 
constricted  portion  by  forming  at  the  neck.  The  portion  which  lies  in 
the  hernial  sac  is  the  body  and  lower  portion.  The  hernial  pouch  is 
absent  in  some  cases — as  a  result  of  some  injury,  and  the  injury  has  been 
severe  enough  to  tear  the  peritoneum,  or  where  the  hernial  pouch  col- 
lapses or  draws  together.  Hernial  coverings  of  the  pouch  are  the  names 
given  to  that  portion  of  the  skin  and  subcutaneous  cellular  tissues  which 
cover  that  part;  in  some  instances  we  also  include  the  muscles  and  apo- 
neuroses. The  contents  of  the  hernia  consist  of  some  portion  of  the 
abdominal  organs  enclosed  in  the  hernial  pouch.  As  a  rule,  it  is  the 
intestines,  in  most  cases  the  duodenum,  and  in  some  cases  the  jejunum. 
Very  frec^uently  the  duodenum  may  be  found  lying  in  the  hernia  with 


382  HERNIAL  RUPTURE 

some  portion  of  the  large  intestine  or  uterus,  and  more  rarely  the  bladder 
or  stomach.  Under  certain  conditions  we  find  a  certain  cjuantity  of 
fluid  lying  in  the  sac.  This  is  generally  serum  and  originates  from 
venous  stagnation. 

According  to  the  location  of  the  hernial  orifice  we  distinguish 
umbilical,  ventral,  inguinal,  scrotal,  and  hernia  of  the  diaphragm. 

The  causes  of  hernia  are  generally  described  as  dii-ect  and  indirect. 
In  the  former  we  have  a  certain  number  of  abnormalities  which  are  due 
to  diseased  conditions.  For  instance,  an  umbilical  hernia  is  due  to  an 
imperfect  closure  of  the  opening  of  the  umbilical  ring.  The  latter  may 
occur  from  the  abdominal  walls  being  flaccid,  from  cicatricial  contrac- 
tions after  operations,  and  occasionally  from  great  abdominal  pressure  in 
prolonged  straining,  vomiting,  etc.,  the  muscular  wall  is  ruptured,  or 
from  kicks  or  blows  on  the  abdomen. 

In  traumatic  hernia  which  has  been  caused  by  blows,  the  hernial 
pouch  is  sometimes  absent  and  its  contents  are  surrounded  by  a  hernial 
envelope — in  most  cases  by  the  skin — and  in  rare  instances  certain 
muscles  are  included  in  the  sac. 

Clinical  Symptoms  and  Course. — The  symptoms  as  well  as  the 
course  show  a  marked  difference,  according  to  the  character  of  the  hernia, 
and  it  depends  to  a  large  extent  on  the  ''possibilities" — that  is  to  say,  if 
the  hernia  can  be  reduced  and  replaced  in  the  abdominal  cavity  or  not. 

Reducible  Hernia. — This  is  generally  seen  in  the  region  of  the  wall 
of  the  abdomen.  AVe  find  a  swelling  which  does  not  present  any  inflam- 
matory symptoms,  and  is  especially  prominent  when  the  animal  is 
walking  or  standing.  It  is  also  seen  during  abdominal  pressure,  espe- 
cially after  the  dog  has  eaten  a  hearty  meal.  If  the  animal  is  turned 
in  such  a  way  that  the  hernia  occvipies  a  superior  position,  as  a  rule  it 
immediately  disappears,  as  the  contents  fall  back  into  the  abdominal 
cavity,  or  they  may  do  so  on  a  slight  pressure  of  the  hand.  If  we  exam- 
ine the  abdominal  walls  the  orifice  of  the  hernia  can  be  distinctly  felt, 
and  we  may  even  be  aljle  to  penetrate  the  abdominal  cavity  with  the 
finger. 

Further  symptoms  depend  upon  the  nature  of  the  prolapsed  intes- 
tines. This  intestine  will  l)e  recognized  as  a  soft,  elastic  swelling, 
having  to  a  certain  extent  the  round  or  tubular  form  of  an  ordinary 
intestine.  It  may  also  l)e  further  distinguished  by  a  slight  distention 
wdiich  is  generally  due  to  gas  or  air.  The  omentum  is  soft  and  doughy 
to  the  touch,  having  an  uneven  surface  and  dull  on  percussion.  Hernias 
of  the  horns  of  the  uterus  are  only  distinguished  from  a  loop  of  intestine 
after  conception  and  during  whelping. 

Mechanical  influences,  such  as  bites,  blows,  contusions  etc.,  may 
cause  inflammation  of  the  hernia  with  a  thickening  of  the  pouch,  and 


ABDOMIXAL  HERXIA  383 

an  adhesion  between  it  antl  the  contents  of  the  hernia.  If  the  injury 
is  severe  enough,  we  may  have  suppuration  in  the  pout-h.  In  such 
cases  we  may  have  a  subsequent  mechanical  contraction  and  reduction 
of  the  hernia,  especially  when  the  pouches  are  small,  or  in  some  cases 
the  hernia  has  only  been  large  enough  to  admit  a  fold  of  the  omentum. 

Irreducible  Hernia. — This  may  be  due  to  an  adhesion  of  the  intes- 
tinal contents  with  the  hernial  pouch,  the  union  of  the  intestinal 
contents  with  each  other  (for  instance,  adhesion  of  the  intestines), 
from  thickening  of  the  omentum  which  lies  in  the  hernial  pouch, 
or  from  strangulation  of  the  hernia.  This  is  especially  important,  as  it 
may  occur  in  all  cases  of  abdominal  hernia  and  at  any  time. 

Concerning  the  causes  of  strangulation  there  are  three  important 
groups:  Strangulation  by  extreme  distention  of  an  intestinal  tube  by 
fiecal  matter;  a  distention  of  the  opening  of  the  hernia,  which  subse- 
quently closes  on  the  intestine  and  strangulates  it;  by  the  intestines 
becoming  twisted  in  the  sac.  Invagination  is  very  frecpently  seen  in 
young  animals. 

In  many  cases  we  distinguish  three  stages  of  hernia,  according  to 
the  anatomical  alterations  produced  as  a  consequence  of  strangulation 
in  the  prolapsed  parts.  First,  we  have  a  venous  hypersemia,  then 
inflammation,  and  lastly  suppuration.  In  the  first  stage  the  veins  and 
capillaries  are  engorged  with  blood,  and  serum  is  exuded  in  different 
directions.  In  the  second  stage  we  observe  inflammation  of  a  septic 
character,  which  extends  from  the  mucous  membrane  to  the  serous 
membrane,  as  a  consecjuence  of  the  noxious  or  poisonous  contents  of  the 
intestines.  In  the  third  stage  the  prolapsed  parts  become  necrosed, 
due  to  the  stricture  of  blood  circulation.  The  intestinal  portion  becomes 
lilack,  easily  torn,  dull  in  color,  and  covered  with  gray  or  greenish  spots 
on  its  surface;  the  hernial  fluid  becomes  purulent,  and  the  inflammatory 
processes  in  the  intestine  above  the  strangulation  cause  septic  peritonitis. 

The  clinical  symptoms  of  strangulated  hernia  are  very  marked 
in  most  cases.  The  hernia  can  no  longer  be  reduced  or  pushed  back 
into  the  cavity,  or  a  swelling  suddenly  appears  after  any  traumatism, 
or  after  great  abdominal  pressure,  and  cannot  be  reduced  even  with 
careful  manipulation.  The  hernia  is  distended,  harder  and  fuller  than 
usual,  becoming  very  sensitive  to  pressure,  and  especially  so  as  the  in- 
flammation becomes  more  intense.  The  skin  covering  the  hernia  is  normal 
in  the  beginning,  but  later  becomes  red,  swollen,  and  warm  to  the 
touch.  Another  symptom  generally  present  is  vomiting.  This  may 
be  so  constant  and  violent  toward  the  later  stages  that  the  animal  will 
vomit  faeces.  At  that  period  symptoms  of  severe  intestinal  obstruction 
present  themselves.  The  hernial  swelling  becomes  cold,  insensilile  to 
pressure,  and  symptoms  of  collapse  appear,  and  death  occurs  in  from 


384  HERNIAL  RUPTURE 

twenty-four  to  forty-eight  hours  after  strangulation  first  appears.  The 
temperature  can  hardly  be  said  to  have  any  diagnostic  value,  as  we  very 
often  find  it  normal  or  even  subnormal  up  to  the  time  of  death. 

In  rare  instances  we  have  the  formation  of  a  fsecal  abscess;  this  is 
caused  by  the  sloughing  of  a  certain  portion  of  the  intestine,  allowing 
the  contents  of  the  intestine  to  escape  into  the  sac;  this  is  due  to  the 
circulation  being  cut  off  and  subsequent  mortification  of  the  part;  this 
is  quickly  followed  by  purulent  inflammation  of  the  hernial  covering. 
If  an  incision  is  made  in  the  hernial  swelling,  faecal  matter  and  pus  flow 
out  externally  without  being  followed  by  any  grave  symptoms,  except 
that  it  may  svibsequently  form  a  false  anus  in  the  cavity. 

Fsecal  fistula,  intestinal  fistula,  or  preternatural  rectum  is  seen  in 
very  rare  instances.  The  expression  "fsecal  fistula"  or  "intestinal 
fistula  "  is  used  where  there  is  an  external  intestinal  orifice,  but  the  greater 
mass  of  fsecal  matter  is  passed  through  the  rectum.  The  term  "  preter- 
natural rectum"  (anus  praeternaturalis)  is  used  when  all  the  fsecal  matter 
passes  through  this  opening.  Such  an  opening  may  also  be  produced 
by  penetrating  wounds  or  the  entrance  of  foreign  bodies. 

In  strangulation  of  the  omentum  the  symptoms  are  less  marked, 
but  there  is  great  pain  on  pressure.  We  frequently  find  adhesions 
between  the  omentum  and  the  orifice  of  the  hernia.  This  inflammation 
produces  a  complete  immobility  of  the  hernia  and  gangrene,  followed 
by  the  formation  of  an  abscess,  and  finally  the  escape  of  pus  externally. 
Death  is  rare  in  such  conditions,  and  if  it  should  occur  it  is  caused  by 
septicsemia. 

The  prognosis  of  irreducible  hernia  depends  greatly  on  the  length 
of  time  that  the  strangulation  has  been  present  and  also  on  the  character 
of  the  contents  of  the  hernia.  In  cases  where  a  loop  of  intestine  is  strangu- 
lated and  is  gorged  wuth  fsecal  matter  the  results  are  generally  serious; 
but,  on  the  other  hand,  strangulation  of  the  omentum  is  not  serious. 

Therapeutics  of  Hernia. — In  cases  of  reducible  hernia  we  cannot 
use  a  truss,  which  is  the  favorite  mode  of  treatment  in  man,  it  being 
impossible  to  keep  a  hernial  bandage  steady  in  any  position  for  any  length 
of  time  on  the  dog.  AVhen  hernia  has  been  caused  in  a  traumatic  way, 
and  followed  by  a  subcutaneous  rupture  of  the  abdominal  wall,  or  in 
umbilical  hernia  of  very  young  animals,  we  may  close  the  orifice  in  such 
cases  by  means  of  a  dressing,  and  the  hernia  may  be  entirely  removed 
by  the  following  method: 

Place  the  animal  on  its  back  or  in  such  a  position  that  the  hernia 
is  placed  as  high  as  possible.  Then  reduce  the  sac  by  working  the  con- 
tents back  into  the  abdomen.  In  some  cases  this  is  accomplished  very 
easily,  but  in  others  it  requires  a  certain  amount  of  careful  and  patient 
manipulation.     Then  place  a  tampon  of  wadding  or  a  small  piece  of 


ABDOMINAL  HERNIA  385 

cardboard  upon  the  hernial  orifice.  This  will  have  to  extend  over  the 
borders  of  the  hernia  far  enough  to  entirely  cover  the  opening.  Now 
fix  small  pieces  of  adhesive  plaster  across  the  cardboard  and  attach 
them  in  a  circle  around  the  piece  of  cardboard.  These  will  adhere  easily 
if  the  skin  has  l)een  cleansed  and  any  fat  or  other  material  has  been 
removed  by  means  of  ether  or  benzine.  [Ordinary  shoemaker's  wax 
made  liquid  is  put  on  the  end  of  the  plaster  strips.]  We  now  place  a 
gauze  bandage  around  the  adhesive-plaster  dressing  and  the  whole 
posterior  part  of  the  body,  in  order  to  protect  the  dressing  from  being 
torn  or  shifted  by  the  animal.  The  dog  should  be  fed  on  light,  easily 
digested  food,  avoiding  any  that  has  a  tendency  to  flatulency  or  consti- 
pation, at  the  same  time  assisting  defecation  by  means  of  laxatives.  The 
safest  and  most  certain  method,  however,  of  removing  hernia  is  the 
operation  of  herniotomy,  or  hernial  section. 

Where  we  have  strangulated  hernia  we  must  attempt  to  reduce  it 
by  pushing  the  contents  of  the  hernia  back  into  the  abdominal  cavity. 
This  may  be  accomplished  either  by  means  of  taxis  or  by  hernial  section. 
The  former  method  is  only  to  be  used  when  the  strangulated  intestines 
have  not  yet  undergone  any  serious  alterations,  namely,  when  they  are 
not  affected  by  gangrene,  and  when  there  are  no  serious  symptoms  of  a 
local  or  general  character.  In  the  operation  of  taxis  the  patient  must 
be  placed  in  such  a  position  that  the  hernia  occupies  the  highest  region 
in  the  abdomen  and  assists  the  relaxation  of  the  abdominal  covering 
and  the  orifice  of  the  hernia  as  much  as  possible.  We  first  try  by  manip- 
ulation upon  the  orifice  of  the  hernia  with  one  hand,  and  by  pressure  of 
the  flat  of  the  other  upon  the  periphery  of  the  swelling  to  push  the  contents 
of  the  hernia  back  into  the  abdominal  cavity.  When  the  animals  are 
under  the  influence  of  ether  or  a  narcotic,  the  reduction  is  easier.  Taxis 
must  be  considered  successful  when  the  swelling  of  the  hernia  has  dis- 
appeared and  when  the  aperture  of  the  hernia  can  be  felt,  and  also  when 
the  symptoms  of  distention  have  gone.  If  the  latter  still  continue, 
notwithstanding  the  fact  that  the  contents  of  the  hernia  seem  to  have 
disappeared,  we  have  a  false  reduction — that  is  to  say,  the  hernial  con- 
tents and  pouch  have  been  shoved  entirely  through  the  orifice  into  the 
al)dominal  cavity,  or  we  have  to  deal  with  a  volvulus  or  invagination 
of  the  intestinal  portion  in  the  cavity;  or  it  may  be  that  the  hernial 
contents  are  crowded  between  layers  of  the  abdominal  muscles.  In  the 
first  instance  the  orifice  of  the  hernia  seems  free,  and  in  the  latter  instance 
it  is  closed. 

If  the  attempts  at  taxis  to  produce  reduction  fail,  or  if  the  above- 
mentioned  contraindications  are  present — that  is,  where  the  hernia  has 
been  left  too  long — we  must  proceed  at  once  to  perform  herniotomy, 
which  must  be  done  under  the  strictest  antiseptic  rules. 


386  HERNIAL  RUPTURE 

Herniotomy  is,  as  a  rule,  a  rather  easy  operation  in  the  dog.  It 
may  be  performed  in  two  ways:  with  or  without  opening  the  hernial 
pouch.  The  former  is  especially  used  in  recent  eases  of  hernia  with 
wide  orifices  and  in  old  cases  of  hernia  wdth  extended  adhesion  of  the 
hernial  contents,  where  the  whole  mass  is  firmly  fastened  together.  The 
latter  method  of  operation  is  used  in  cases  of  hernia  which  are  not  com- 
plicated with  a  hernial  pouch,  in  strangulated  hernia  with  considci-alile 
alteration  of  the  contents,  or  with  a  very  narrow  hernial  opening.  These 
conditions,  however,  are  only  distinguished  during  the  course  of  the 
operation,  and  we  are  then  forced  to  change  from  the  first  to  the  second 
method  of  operation.  In  both  methods  the  skin  of  the  operated  region 
must  be  shaved  and  carefully  disinfected.  We  then  lift  up  a  fold  of  the 
skin  corresponding  with  the  axis  and  the  length  of  the  hernia  and  split 
it  open  with  a  longitudinal  incision.  This  must  be  made  very  carefully 
until  we  reach  the  hernial  pouch.  This  is  recognized  by  its  irregular 
surface,  which  is  of  a  grayish-yellow  color;  also  by  the  fact  that  it  is 
impossible  to  get  an  ordinary  sound  directly  into  the  abdominal  cavity, 
and  when  the  sac  is  pressed  by  the  fingers,  the  hernial  contents  will 
slip  back,  if  the  hernia  is  an  old  one,  it  is  whitish-gray  in  color  but  if 
strangulated,  it  is  deep  purple-red  in  color. 

Having  carefully  dissected  out  the  sac  until  it  is  completely  sepa- 
rated from  the  surrounding  tissue,  taking  care  not  to  injure  the  contents, 
we  follow  one  of  the  two  methods  before  spoken  of — that  is,  not  opening 
or  opening  the  hernial  pouch. 

In  the  former  case  we  introduce  by  means  of  the  index  finger  a 
probe-pointed  bistoury  or  herniotome  between  the  neck  of  the  hernia 
and  its  orifice,  turning  the  cutting  edge  of  the  knife  toward  the  neck  or 
restricted  portion,  the  dull  side  of  the  knife  being  toward  the  hernia 
pouch.  By  means  of  a  very  small  incision  the  tension  becomes  greatly 
relaxed,  and  reduction  is  easily  accomplished.  If  the  opening  of  the 
hernial  pouch  is  required,  we  hold  up  one  of  its  folds  with  a  pair  of  forceps 
and  split  it  by  means  of  a  knife  held  flat  or  a  pair  of  scissors.  After  the 
discharge  of  the  fluids  in  the  hernial  sac  a  notch  is  cut  in  the  hernial 
pouch  by  means  of  the  herniotome.  The  exposed  loop  of  intestine  is 
reduced  by  the  method  just  described,  by  cutting  through  the  constricted 
portion  and  working  the  intestine  back  in  such  a  way  that  the  portion 
of  the  intestine  which  was  prolapsed  last  must  be  reduced  first. 

If  the  intestine  is  much  distended  by  gas,  it  may  be  emptied  by 
means  of  a  puncture  of  a  very  fine  trocar  (or  the  canula  of  a  large  hypo- 
dermic syringe).  Any  degenerated  portions  of  the  epiploon  must  be 
amputated  after  being  ligated.  If  the  intestine  is  intensely  inflamed  or 
gangrenous,  we  must  either  resect  it  or  make  an  artificial  anus. 

After  reducing  the  hernia  we  must  close  the  hernial  orifice.      This  is 


INGUINAL  AND  SCROTAL  HERNIA 


387 


forcibly  drawn  out  and  twisted  round  and  round  in  a  spiral  direction,  and 
a  single  or  doul)le  ligature  applied  as  high  up  as  possible.  In  cases  where 
no  hernial  pouch  is  presented  or  it  has  been  shoved  back  into  the  abdom- 
inal cavity  it  is  advisable  to  freshen  the  borders  of  the  orifice  by  means 
of  a  blunt  knife  or  curette;  then  stitch  it  up  by  a  continuous  suture  of 
catgut.     After  thoroughly  disinfecting  it  for  the  second  time,  the  external 


Fig.  126. — Scrotal  hernia  of  right  side. 

wound  is  to  be  stitched  and  covered  with  an  antiseptic  dressing  held  in 
position  by  niBans  of  a  bandage  (eight-tailed)  around  the  body. 

Inguinal  and  Scrotal  Hernia. 

{Hernia  Inguinalis  and  Scrotalis.) 

The  inguinal  canal  of  the  dog  is  located  in  the  abdominal  muscles 
with  the  seminal  cord,  and  runs  from  the  testicles  into  the  abdominal 
cavity.  In  the  bitch  we  find  a  round  ligament  from  the  end  of  the  Fallo- 
pian tube  toward  the  subcutis.     Inguinal  hernia  may  be  produced  by  a 


388  HERNIAL  RUPTURE 

portion  of  the  intestine  passing  from  the  abdominal  cavity  into  the 
inguinal  canal.  If  this  is  the  case  in  the  dog,  and  the  loop  of  the  intestine 
goes  as  far  as  the  scrotum,  we  call  it  scrotal  hernia.  If  it  simply  lies  in 
the  canal,  it  is  called  inguinal  hernia. 

Clinical  Symptoms  of  Inguinal  and  Scrotal  Hernia  in  the  Male  Dog. 

This  condition  is  very  rare  in  the  male;  most  cases  are  congenital; 
the  contents  are  generally  small  intestine  and  omentum.  In  an  ordinary 
case  of  inguinal  hernia,  we  must  understand  that  from  the  external 
abdominal  ring  as  far  as  the  scrotum  the  canal  is  almost  cylindrical, 
and  we  find  tnat  when  this  canal  is  filled  either  with  a  loop  of 
small  intestine  or  omentum  it  has  a  peculiar  elastic  softness  and 
"doughy"  feel  under  the  skin.  There  is  generally  no  local  increase 
of  temperature.  In  large  hernias  we  may  reduce  this  partially  or  alto- 
gether by  placing  the  animal  on  its  back  and  holding  up  the  hind 
quarters  and  gently  pressing  or  rul^bing  with  the  finger  upon  the  hernial 
swelling.  If  the  intestine  has  entered  the  scrotum  (Fig.  126) ,  the  affected 
side  appears  full  and  large,  and  may  be  reduced  by  the  manipvdations 
indicated  above.  In  hernias  of  this  character  the  testicle  is  apt  not  to 
descend  into  the  scrotum,  and  is  soft,  immature,  and  can  be  distinguished 
in  the  canal.  The  abdominal  ring  is  found  to  be  larger  than  natural. 
In  cases  of  strangulation  the  symptoms  which  have  been  descril^ed  before 
become  apparent,  and,  if  the  symptoms  are  very  acute  and  all  attempts 
at  reduction  are  futile,  we  must  perform  the  operation  of  castration. 

Castration  of  the  Male. — In  normal  conditions — that  is  to  say,  when 
no  hernia  is  present — castration  of  the  dog  must  be  performed  by  laying 
the  animal  on  his  side,  rendering  all  the  parts  aseptic,  and  holding  the 
skin  tightly  over  the  testicle,  compressing  it  between  the  finger  and 
thumb.  Then  make  an  incision  the  entire  length  of  the  scrotum,  cutting 
through  the  scrotum,  the  tunica  dartos,  and  tunica  vaginalis,  so  that 
the  testicle  is  exposed  (compare  with  Fig.  127). 

The  testicle  is  drawn  out  and  then  the  common  intersecting  membrane 
is  opened  up  as  far  as  possible  by  means  of  a  pair  of  scissors;  then  place 
a  strong  silk  suture  around  the  seminal  cord,  close  up  to  the  inguinal 
ring,  and  ligate  it.  "When  this  is  done,  the  seminal  cord,  with  all  the 
superfluous  portions  of  the  interstitial  membrane,  is  amputated  aliout  1 
cm.  below  the  ligature.  The  other  testicle  must  be  removed  in  the  same 
manner.  After  carefully  cleansing  the  wound  with  a  strong  non-irritant 
disinfectant,  the  wound  of  the  scrotum  has  to  be  closed  Avith  an  ordinary 
stitch,  and  it  is  advisal)le  to  place  a  small  drain,  like  a  silk  thread,  into 
one  of  the  corners  of  the  wound.  No  dressing  is  recjuired  provided  the 
animal  is  muzzled.  Ilealing  occurs  generally  within  a  few  days.  If, 
however,  we  have  a  case  in  which  we  wish  to  operate  for  inguinal  or 


INGUINAL  AND  SCROTAL  HERNIA 


380 


scrotal  hernia,  we  deviate  from  the  above-described  method  of  castration 
by  ligating  the  intersecting  membrane  externally  and  as  close  as  possible 
to  the  external  inguinal  ring,  having  first  twisted  the  sac  several  times, 
the  wound  is  sewed  up  and  a  bandage  put  on  for  several  days.  In  valu- 
able breeding  animals  the  testicle  of  the  affected  side  only  is  removed. 

Inguinal  Hernia  in  the  Bitch. — This  is  generally  observed  in  bitches 
that  have  had  puppies,  although  it  has  also  appeared  early  in  life  from 
no  apparent  cause.  It  is  also  congenital.  Gutman  saw  a  bitch  three 
months  old  that  had  an  inguinal  hernia.     This  condition  is  either  lateral 


Fig.  127. — Genital  organs  of  the  dog:  1,  Scrotum  opened;  2,  right  testicle;  3,  body  of  the  epididy- 
mis; 3',  globus  major  and,  3",  globus  minor;  4,  spermatic  cord;  5,  vas  deferens;  6,  prepuce  (partially 
dissected);  7,  free  portion  of  the  penis;  7',  posterior  attachment  of  the  penis;  8,  erectile  masses  (bulbous 
bodies);  8',  size  of  erectile  masses  when  distended  by  blood. 

or  bilateral.  The  hernial  sac  in  this  condition  is  doul^le,  the  internal 
being  peritoneum,  the  external  the  skin  and  part  of  the  mammary 
gland.  In  a  hernia  of  any  size  we  find  it  invariably  contains  the 
uterus,  particularly  when  that  organ  is  heavy  with  foetus,  or  other 
abdominal  organs,  for  instance  the  bladder,  loops  of  intestine,  or  the 
omentum.  Cadeac  found  in  a  unilateral  inguinal  rupture  the  size  of 
a  child 's  head  on  the  right  side,  the  entire  intestinal  tract  and  on  the 
left    side    the   omentum,    the    spleen,    uterus    and    the    bladder.     An 


390 


HERNIAL  RUPTURE 


inguinal  hernia  in  the  l)itch  if  it  is  of  any  size  is  easily  recognized  (Fig. 
128) .  It  is  found  in  the  posterior  part  of  the  mammary  gland,  an  enlarge- 
ment varying  in  size,  elastic,  painless,  with  no  increase  of  the  local  tem- 
perature. When  the  animal  is  placed  on  her  back,  it  either  returns  to 
its  normal  position  by  natural  gravitation  or  else  it  is  reduced  with  very 
little  manipulation.  On  the  return  of  the  contents  of  the  hernial  sac  the 
abdominal  ring  is  found  to  be  very  much  dilated  above  normal.  In 
rare  instances  it  may  be  found  impossible  to  reduce  the  hernia  entirely, 
and  this  is  found  to  be  due  to  certain  adhesions  of  the  abdominal  contents 
to  the  pouch  or  else  to  a  pregnant  uterus;  in  the  latter  case  the  fcBtus  can 


Fig.  128. — Inguinal  hernia  of  bitch. 

easily  be  detected  by  manipulation.  In  certain  cases  where  there  is  a 
doubt  as  to  the  exact  nature  of  an  enlargement  in  the  position  of  inguinal 
hernia,  if  it  is  the  uterus  in  the  sac,  on  introducing  the  finger  into  the 
vagina,  that  is  found  to  be  elongated  and  deviated  to  one  side,  due  to 
the  stretching  and  weight  of  the  uterus,  and  it  is  also  found  that  it  is 
impossible  to  reach  the  os  uteri  with  the  end  of  the  finger.  In  very  rare 
cases  when  the  round  ligament  of  the  uterus  (false  inguinal  hernia)  is 
greatly  hypertrophied,  it  might  be  possible  to  mistake  it  for  inguinal 
hernia.  (False  inguinal  hernia.)  As  a  rule  inguinal  hernia  in  the  bitch 
is  rarely  involved  in  strangulation,  and  if  s^hc  should  be  in  whelp,  she 
has  her  puppies  without  trouble. 

A  bitch  affected  with  inguinal  hernia  nuist  be  carefully  fed,  avoiding 


UMBILICAL  HERNIA  391 

food  that  is  hard  to  digest,  or  has  a  tendency  to  cause  flatulence  or  to  con- 
stipate. If  it  becomes  necessary  to  remove  the  hernia,  either  from  size  or 
strangulation,  herniotomy  should  be  performed  with  the  animal  under  an 
anajsthetic,  and  operated  on  as  already  described  (see  Herniotomy). 

Sarcocele. — This  is  a  collective  name  for  all  kinds  of  tumors  of  the 
testicles,  especially  for  sarcoma,  carcinoma,  enchondroma,  and  cysts. 
The  testicles  are  swollen,  the  swelling,  as  a  rule,  being  hard,  tough,  and 
sometimes  fluctuating;  never  warm  or  very  painful.  The  condition 
can  only  he  remedied  by  castration. 

Hydrocele. — By  this  we  define  an  accumulation  of  fluid  (serum)  in 
the  scrotum.  The  affection  is  often  associated  with  oedema  of  the  lower 
extremities  and  of  the  scrotum.  It  is  frequently  seen  with  ascites, 
hydrothorax,  etc.,  appearing  in  the  shape  of  a  fluctuating  swelling  of 
the  testicular  pouch,  Avhich  disappears  when  the  animals  lie  on  their  backs. 

Therapeutic  Treatment. — This  consists  of  puncture  and  emptying 
of  the  sac,  also  injection  with  any  of  the  following  stimulating  fluids; 
alcohol,  Lugol's  solution,  carbolic  acid  (1  to  40),  etc.  Of  course,  these 
are  only  to  be  used  when  castration  is  not  performed. 

A  variety  of  hydrocele  is  seen  where  we  have  oedema  of  the  spermatic 
cord.  This  appears  as  a  fluctuating  swelling  which  may  be  easily  moved 
from  one  side  to  the  other.  It  occupies  the  whole  length  of  the  spermatic 
cord,  and,  as  a  rule,  is  never  interfered  with.  When  the  fluid  of  the 
hydrocele,  which  is  discharged  by  puncture,  consists  of  bloody  serum, 
we  call  it  haemorrhagic  hernia,  or  hsematocele.  Any  other  complications 
of  the  testicles  and  their  membranes  may  be  found  on  page  208. 

Umbilical  Hernia. 

{Hernia  U»ibiliculiti). 

The  hernia  ring  is  formed  by  the  umbilical  ring.  The  contents 
may  consist  of  the  omentum,  duodenum,  and  in  rare  cases  of  the  large 
intestine.  In  the  hereditary  form  the  intestines  are  located  in  the 
umbilical  cord,  and  are  not  covered  by  the  abdominal  membrane  (hernia 
of  the  umbilical  cord).  In  accidental  hernia  of  the  uml:)ilicus,  we  always 
have  a  hernial  pouch,  originating  from  the  peritoneum.  As  a  rule, 
umbilical  hernia  occurs  a  few  days  after  birth.  It  may  increase  gradually 
and  beeome  eventually  strangulated,  but  it  often  disappears  without  any 
surgical  interference.  Hernia  of  the  omentum  we  see  occasionally,  but 
generally  it  cures  itself  by  an  adhesion  between  the  hernial  pouch  and 
the  hernial  ring.  Umbilical  hernia  is  easily  recognized  (Fig.  129).  We 
find  a  swelling  under  the  umbilical  ring,  which  may  vary  in  size  from  a 
hazelnut  to  a  walnut. 

Therapeutics. — Treatment  consists,  as  a  rule,  in  very  young  animals, 


392 


HERNIAL  RUPTURE 


of  the  application  of  a  bandage  over  the  hernia  and  kept  there  for  three 
or  four  weeks,  thus  holding  the  abdominal  contents  back  and  allowing 
the  opening  to  close  spontaneously.  The  bandage  consists  of  a  tampon 
of  lint  which  is  fixed  to  a  piece  of  rubber  adhesive  plaster  or,  better  still, 
the  round  top  of  a  bicycle  repair  plug  with  the  stem  cut  off,  then  adhesive 
rubber  plaster  is  placed  in  strips  in  a  circle,  as  per  Fig.  130.  Before 
applying  the  plaster  it  is  wellto  clean  off  the  skin  on  the  region  of  the 


X-^UdiLJiiA^^^^ 


Fig.  129. — Umbilical  hernia. 

umlnlicus  with  ether  or  benzine  to  get  better  adhesion.  Shoemaker's 
wax  is  also  used  as  an  adhesive  substance.  It  is  best  to  put  a  strip  band- 
age around  the  body  to  retain  the  bandage  in  position. 

Another  more  certain  method  is  to  place  the  animal  on  his  back, 
reduce  the  hernia;  the  hernial  pouch  is  pulled  away  from  the  body,  and 
a  needle  carried  through  the  centre  of  the  base  of  the  sac,  the  thread  is 
cut  through  at  the  needle  and  then  each  side  of  the  ligature  knotted, 
dividing  the  tumor.  Almost  immediately  the  tumor  dries  and  mummi- 
fies, and  in  a  w^eek  or  ten  days  falls  off  with  the  stitches,  leaving  a  raw 


Fig.  130. — Plaster  on  umbilical  hernia. 

surface  which  is  painted  with  compound  tincture  of  benzoin  daily  and 
soon  dries  up.  Care  is  to  be  taken  to  prevent  the  animal  licking  or 
chewing  the  part  until  it  is  healed. 

Injections  of  corrosive  substances,  such  as  solution  of  chromic, 
nitric,  or  sulphuric  acid,  are  not  to  be  recommended,  as  likewise  are 
salves  of  cantharides,  collodion,  subcutaneous  injections  of  absolute 
alcohol,  chloride  of  zinc   or  chloride  of  sodium. 


FEMORAL  HERNIA 


393 


Femoral  Hernia. 

{Hernia  Cruralis.) 

Femoral  hernia  is  extremely  rare  in  the  clog.  The  ring  is  formed 
by  the  upper  end  of  the  so-called  femoral  canal,  and  is  formed  by  the 
crural  fascia,  the  external  membrane  forming  the  hernial  covering.  The 
femoral  canal  of  the  dog  is  a  long,  three-cornered  cavity  in  the  median 
surface  of  the  upper  part  of  the  leg,  which  is  surrounded  front  and  back 
by  the  inverted  muscles  of  the  upper  thigh — that  is  to  say,  in  front  by 
the  sartorius  muscle,  and  back  by  the  long  abductor,  the  large  and  short 
abductor,  and  on  its  upper  surface  by  the  ilio-psoas,  while  the  floor  of 
the  cavity  is  formed  by  a  portion  of  the  muscles  of  the  thighs  and  by  the 
crural  fascia.  Below  the  borders  of  the  sartorius  the  abductors  run 
together  at  an  acute  angle  (Fig.  131).  This  canal,  as  a  rule,  is  filled  with 
masses  of  fat,  nerves,  and  blood  vessels.  In  cases  of  fracture  of  the 
pelvis  the  intestines  which  leave  the  abdominal  cavity,  after  having 
followed  the  direction  of  the  large  blood  vessels,  locate  themselves  in  this 


Fig.  131. — Middle  section  through  the  pelvis,  showing  the  organs:  a.  Pelvis;  h,  coccygeal  vertebra; 
c,  broad  pelvic  ligament;  (/,  anterior  and,  d',  posterior  portions  of  the  rectum;  e,  bladder;  /,  /,  seminal 
vesicles;  g,  fold  of  the  peritoneum. 

cavity  and  are  covered  by  the  peritoneum,  the  crural  fascia,  and  external 
membrane;  but  they  may  also  under  certain  conditions  penetrate 
directly  under  the  skin  through  an  opening  of  the  crural  fascia. 

In  the  inner  fascia  of  the  thigh  we  find  a  soft  swelling  which  has 
more  or  less  pain  when  the  condition  is  examined  and  the  disease  has 
been  of  recent  origin,  and  in  cases  of  strangulation.  In  the  latter  cases, 
however,  we  see  also  a  peculiar  dragging  motion  of  the  thighs,  with 
lameness  and  symptoms  of  intestinal  obstruction,  such  as  vomiting,  etc. 
Herniotomy  has  to   be   performed   according  to   the  rules  mentioned 


394 


HERNIAL  RUPTURE 


before,  but  must  only  he  attempted  in  extreme  cases.  In  making  incisions 
into  this  region  great  care  must  be  taken  to  avoid  the  large  blood  vessels 
which  pass  into  and  through  the  femoral  canal. 

Perineal  Hernia. 

Perineal  hernia  occurs  in  both  dogs  and  bitches.     In  the  former  it 
is  recognized  by  a  peculiar  bulging  or  lifting  of  the  recto-vesicalis,  and  in 


Fig.   132. — Double  perineal  hernia. 

the  latter  by  a  bulging  of  the  vesico-uterina.  In  both  cases  we  observe 
prolapse  of  the  duodemmi  or  lower  bowel,  and  sometimes  in  the  dog  we 
observe  a  prolapse  of  the  bladder. 

In  the  dog  we  recognize  perineal  hernia  by  a  soft  swelling  the  size 
of  an  egg  or  the  size  of  the  hand.  This  appears  in  the  side  and  above 
the  anus,  between  the  root  of  the  tail  and  the  tul^er  ischii  (Fig.  132). 
In  the  bitch  this  hernial  swelling  is  seen  under  the  vulva  and  on  the 
peritoneum.  This  hernia  can  only  be  removed  by  means  of  an  operation, 
and  unless  it  is  either  very  large  or  shows  indications  of  strangulation,  it 
had  best  be  left  alone.  To  operate  the  parts  should  be  thoroughly 
cleaned  with  antiseptic  washes,  the  skin  shaved,  the  animal  etherized, 
and  an  incision  made  in  the  skin,  then  the  hernial  sac  is  emptied  of 
its  contents  and  ^the  sac  pulled  out  as  far  as  possible,  and  ligated  and 
the  free  part  of  the  sac  cut  off.  In  case  there  are  adhesions  between 
the  contents  of  the  sac  and  the  sac  itself,  the  pouch  must  be  opened  and 
the  adhesions  carefully  torn  away,  and  pushed  back  into  the  abdominal 
cavity,  the  pouch  ligated  as  already  described. 


DISEASES  OF  THE  EYES. 
AFFECTIONS  OF  THE  EYELIDS. 

Adhesion  of  the  EyeUds.     Ankyloblepharon. 

It  is  a  well-known  fact  that  puppies  are  born  blind — that  is  to  say, 
the  palpebral  fissure  is  closed  at  birth  (atresia  palpebrarum).  This  is 
not  a  simple  agglutination  of  the  eyelids,  but  a  true  adhesion  of  the 
membranes.  This  has  been  proven  from  the  fact  that  if  they  are  forcibly 
separated  after  birth,  the  cornea  has  an  opaque  look  and  the  edges  of 
the  eyelids  bleed.  As  a  rule,  the  fissure  opens  in  from  seven  to  twelve 
days.  It  is  very  rare  that  we  have  an  obstinate  closure  of  the  eyelids. 
If  this  should  be  the  case,  we  try  to  produce  separation  by  means  of  emol- 
lients, tepid  water,  and  normal  tension  upon  the  eyelids.  If  these  are 
not  successful,  the  eyelids  must  be  separated  l)y  means  of  a  pair  of  scis- 
sors or  a  probe-pointed  curved  bistoury.  Then  we  rub  the  edges  of  the 
wound  with  vaseline  or,  if  they  persist  in  uniting,  with  caustics,  nitrate 
of  sdver  pencil,  in  order  to  prevent  an  adhesion.  In  very  rare  instances, 
as  a  consequence  of  traumatisms,  burns  or  excoriations,  we  may  find 
more  or  less  adhesion  and  narrowing  of  the  lids  (ankyloblepharon,  bleph- 
arophimosis) . 

Entropion — Turning  In  (Inversion)  of  the  Eyelid. 

By  this  term  we  understand  a  turning  or  wrinkling  of  the  eyelid  in 
such  a  manner  that  the  edge  of  the  lid  is  directed  toward  the  eyeball 
and  the  eyelashes  come  in  contact  with  the  conjunctival  tissues  and 
cornea.  Entropion  occurs  cjuite  frequently,  especially  in  bulldogs, 
Newfoundlands,  setters.  Great  Danes  and  spaniels,  although  it  may  be 
present  in  all  breeds.  In  some  cases  it  is  present  at  birth,  or  it  may  be 
developed  by  constant  convulsive  closing  of  the  fissure  of  the  e)'e 
(blepharospasmus) ,  due  to  some  chronic  in-itating  conditions  of  the 
cornea  or  conjunctiva  (conjunctivitis  chronica,  conjunctivitis  follicu- 
laris).  It  is  occasionally  caused  by  cicatricial  contraction  of  the  con- 
junctiva of  the  lid,  after  injuries,  such  as  the  result  of  caustic  substances 
getting  in  the  eyes,  burns,  or  some  chronic  inflammatory  condition,  or 
to  atrophy  of  the  eyeball.  The  more  relaxed  the  cutaneous  tissue  may 
be  in  the  neighborhood  of  the  eyelid,  the  more  obstinate  the  diseased 

395 


396 


DISEASES  OF  THE  EYES 


condition  is  to  treat.  Haltanhoff  considers  that  the  tendency  to  entropion 
is  hereditary. 

Clinical  Symptoms. — As  a  rule,  the  inversion  of  the  lid  occurs  more 
frequently  in  the  upper  than  the  lower  eyelid,  but  we  may  also  see  both 
affected  at  the  same  time.  Sometimes  we  see  a  lateral  inversion  of  the 
eyelid.  This  is  extremely  rare,  however.  A  symptom  observed  is 
constant  irritation,  which  is  caused  by  the  hair  of  the  lashes  being 
directed  toward  the  cornea.  We  also  see  a  marked  increase  in  lachrymal 
secretion,  a  twitching  and  convulsive  compressing  of  the  eyelids,  and  a 
thick,  gray,  purulent  mucus  accumulates  in  the  corners  of  the  eyes. 
The  hairs  of  the  eyelashes  become  adherent,  and  the  eyelids  may  become 
completely  glued  together.  Besides  this  we  see  an  intense  inflammatory 
condition  of  the  connective  tissue,  and  in  some  cases  inflammation  of  the 
cornea,  and  in  extremely  bad  cases  ulceration  (ulcerative  keratitis). 

The  prognosis  may  be  favorable  when  we  operate  at  the  proper 


Fig.   133. — Entropion  operation  of  lower  eyelid. 

time,  but  relapses  are  not  rare,  especially  in  dogs  which  show  a  peculiar 
wrinkled  condition  of  the  facial  membrane.  We  may  expect  a  relapse 
in  such  cases  where  we  do  not  entirely  remove  the  conjunctivitis  (primary 
or  secondary)  at  the  same  time  as  the  entropion. 

Therapeutics. — It  is  only  in  fresh  and  very  mild  forms  of  the  disease 
that  we  may  expect  to  obtain  any  favorable  results  by  means  of  medicinal 
treatment,  and  this  must  be  directed  toward  removing  the  conjunctivitis 
which  exists  in  conjunction  with  entropion,  otherwise  an  operation  alone 
will  answer. 

The  following  methods  of  operation  are  suggested: 
The  best  method  is  to  carefully  remove  the  hair  and  thoroughly 
disinfect  the  surrounding  tissue,  and  a  fold  of  tissue  running  parallel  to 
the  edge  of  the  lid  is  picked  up  by  means  of  a  pair  of  entropion  or  ordi- 
nary artery  forceps,  the  fold  of  skin  lifted  ]:)eing  sufficiently  large  to 
make  the  lid  lie  in  its  normal  position,  care  being  taken  not  to  include 
the   conjunctiva,   and  this  fold  is  cut  at  the  edge  of  the  forceps;  there 


ECTROPION—TURNING  OUT  OF  THE  EYELID 


397 


must  be  at  least  0.5  cm.  between  the  edge  of  the  wound  and  the  edge  of 
the  eyelid;  the  hemorrhage  must  be  completely  controlled  before  the 
wound  is  closed  with  several  silk  sutures  (Fig.  133).  Where  there  is 
extensive  inversion  of  the  lid,  it  is  ])est  not  to  attempt  to  remove  too 
large  a  portion  of  the  lid,  but  divide  it  into  two  portions  and  equalize 
the  tension,  as  illustrated  in  the  accompanying  figure.  The  portion  may 
be  removed  either  on  the  upper  or  lower  lid,  and  also  at  the  lateral 
corner  of  the  eye  a  portion  in  a  vertical  position  can  be  removed,  and  in 
extreme  cases  of  entropion,  all  three  excisions  can  be  performed  (Fig.  134). 
Another  method  recommended  by  Schleich  consists  in  removing  a  piece 
of  skin  in  the  form  of  an  arrow-head  (see  Fig.  135)  and  uniting  the 
edges  with  sutures. 


Fig.   134. 


Fig.   135. 


Fig.    134. — Diagrammatic  position   of  sections  and  mode  of  stitching  in  the  operation  for  entropion. 

(C.  Miiller.) 
Fig.   135. — Diagrammatic  position  of  section  in  operation  of  entropion.      (Schleich.) 

The    simple   removal   of  the   inverted  eyelid  by  means  of  scissors, 

is  undoubtedly  the  simplest  method,  but  it  is  very  evident  that  not 
only  is  the  appearance  of  the  animal  very  much  impaired  by  it,  but  that 
the  eyeball  may  be  constantly  irritated  and  there  is  a  constant  flow  of 
tears  on  account  of  the  insufficient  closure  of  the  lid. 

Tying  up  small  portions  of  the  lid,  by  means  of  needles,  or  the 
method  recommended  by  Brennen  of  burning  a  series  of  lines  on  the  lid 
by  means  of  thermo-cautery,  which  afterward  heal  and  by  cicatricial 
contraction  draw  the  lid  back,  are  not  as  efficacious  as  the  proceedings 
first  described. 


Ectropion — Turning  Out   (Eversion)   of  the  Eyelid. 

This  condition  is,  as  a  rule,  in  the  lower  lid,  the  free  edge  of  the  lid 
being  turned  out  from  the  eyel)all  toward  the  external  side  of  the  eyelid. 
This  is  generally  noticed  in  bulldogs,  St.  Bernards,  and  setters,  especially 
so  in  animals  that  have  sunken  eyeballs.     It  may  be  due  to  an  alteration 


39S 


DISEASES  OF  THE  EYES 


or  partial  paralysis  of  the  palpebral  muscles.  Sometimes  it  may  occur 
from  the  shape  of  the  cartilage,  which  does  not  consist  of  a  firm  disk,  but 
of  bunches  or  collections  of  connective  tissue  mixed  with  elastic  fibres. 
In  some  cases  it  may  be  caused  by  a  contraction  of  some  of  the  tissues  of 
the  face,  especially  from  cicatricial  contraction,  as  a  result  of  wounds  or 
burns.  It  may  also  be  due  to  a  loosening  or  softening  of  the  tarsal  cartil- 
age as  a  result  of  prolonged  conjunctivitis. 

Clinical  Symptoms. — The  affected  eyelid  is  turned  up  and  out,  so  as 
to  show  the  conjunctiva.  The  latter  is  inflamed  from  the  action  of  the 
air  and  is  more  or  less  reddened,  and  at  the  same  time  there  is  consideraljle 
secretion  of  mucus  and  tears  along  the  cheeks  (lachrymal  eyes). 

Therapeutic  Treatment. — If  it  is  due  to  conjunctivitis,  we  must  first 
endeavor  to  I'educe  it  by  ''touching"  the  connective  tissue  of  the  eyelid 
with  a  pencil  of  nitrate  of  silver  or  sulphate  of  copper,  or  by  removing  a 
portion  of  the  mucous  membrane  of  the  lower  eyelid.     This,  however 


Fig.  136.  Fig.  137. 

Figs.   136  and  137. — Entropion  operation  and  mode  of  .stitching.      {Cadiot-Breton.) 

is  extremely  hard  to  do,  and  as  a  rvile  it  is  not  advisable.  If  these 
measures  are  useless,  or  if  they  seem  doubtful  from  the  onset,  Moller 
recommends  to  excise  from  the  external  half  of  the  affected  lid  an 
arrow-shaped  or  nearly  triangular  piece  of  skin  and  unite  it  by  means  of 
sutures  (Figs.  130,  137).  Frick's  method  of  excising  two  crescent-shaped 
pieces  of  skin  whose  concavities  are  toward  the  lid  and  meet  at  an 
angle,  2  to  3  cm.  from  the  edge  of  the  lid,  and  uniting  the  edges  by 
means  of  button  sutures,  has  not  been  found  to  be  as  satisfactory  as  the 
first-mentioned  operation. 

Inflammation  of  the  Eyelids.  Blepharitis. — This  condition  appears 
as  an  inflammation  of  the  external  covering  of  the  lid  (B.  superficialis), 
inflammation  of  the  cellular  tissue  of  the  lid  (B.  profunda),  and  inflam- 
mation of  the  edge  of  the  lid  (B.  ciliaris).  Superficial  inflammation  of 
the  lid  is  generally  caused  by  some  irritation  that  involves  the  skin  of  the 
surrounding  tissues,  such  as  eczema  or  parasitic    mange,   particularly 


ECTROPION— TURNING  OUT  OF  THE  EYELID  399 

sarcoptic  or  dermodectic  mange  (B.  acarica).  General  inflammation 
of  all  the  structures  of  the  lid  is  caused  by  direct  traumatisms,  bites, 
tears  from  sharp  objects,  and  is  invariably  accompanied  with  pro- 
nounced tumefaction  and  subsequent  suppuration;  sometimes  it  may 
even  terminate  in  an  abscess.  Inflammation  of  the  edge  of  the  lid  is 
generally  confined  to  the  affected  edge  and  is  covered  by  a  tenacious 
purulent  mucus  that  sticks  the  edges  of  the  lid  together;  this  secretion 
varies  in  color,  at  first  graj'ish-yellow,  then  light  brown  and  finally  dark 
reddish-brown. 

The  treatment  consists  first,  in  frequent  fomentations  of  boracic 
acid  solution,  or  strong  infusions  of  ordinary  tea,  with  a  pinch  of  borax 
in  it,  and  the  edges  of  the  lid  should  be  covered  with  ointment  of  red 
oxide  of  mercury.  General  inflammation  of  the  lid  (B.  profunda) 
should  be  treated  with  warm  fomentations  and  if  an  abscess  forms  it 
should  be  opened  as  soon  as  it  points.  B.  acarica  is  taken  up  under 
parasitic  skin  diseases. 

Hordeolum.  Sty. — Sty  is  due  to  an  inflammation  of  one  of  the 
glands  of  the  hair  follicles  of  the  eyelash  or  of  a  Meibomian  gland.  It 
is  indicated  Ijy  a  small  bright  red  globular  tumor  on  the  edges  of  the  lid, 
with  more  or  less  redness  and  tumefaction  of  the  surrounding  tissues. 
It  may  be  chronic  (chalazion),  but  that  is  extremely  rare. 

The  treatment  consists  in  warm  application  of  boracic  acid  solution 
applied  frequently,  and  if  an  abscess  has  formed  it  must  be  carefully 
opened  by  means  of  a  fine  needle;  forcil)ly  squeezing  the  lid  to  evacuate 
the  contents  does  more  harm  than  good.  In  chronic  cases  remove  the 
tumor. 

Diseases  of  the  Lachrymal  Organs  and  the  Membrana  Nictitans. — 
The  lachrymal  organs  are  very  rarely  affected  in  the  dog.  Inflammation 
of  the  lachrymal  duct  generally  appears  as  a  secondary  complication  of 
catarrh  of  the  conjunctiva.  It  appears  as  a  round  circumscribed  tumor, 
which  is  immovably  fixed  in  the  corner  of  the  eye,  and  on  pressure  a 
cjuantity  of  mucus  or  muco-purulent  fluid  exudes  from  the  lachrymal 
opening.  In  acute  inflammation  of  the  duct,  if  the  end  of  the  duct  is 
closed  by  inflammatory  processes,  it  is  apt  to  break  out  through  some 
portion  of  the  duct,  which  may  discharge  a  muco-purulent  fluid  for  a 
time  or  else  form  a  permanent  fistula;  this  condition  is  extermely  rare, 
and  occasionally  we  may  find  that  an  abscess  at  the  root  of  one  of  the 
molars  has  caused  a  fistulous  opening  near  the  canal;  careful  probing 
with  a  sound  will  generally  enable  one  to  make  a  correct  differential 
diagnosis. 

Stenosis  and  obstruction  of  the  lachrymal  canal  is  due  to  inflamma- 
tion of  the  mucous  membranes,  traumatisms,  foreign  bodies,  tumors. 
Closure  of  the  opening  of  the  canal  is  indicated  by  the  constant  flow  of 


400 


DISEASES  OF  THE  EYES 


tears  from  the  internal  angle  of  the  eyes,  irritation  of  the  skin,  and  loss 
of  hair  below  the  opening. 

Hypertrophy  of  the  lachrymal  canal  is  duo  to  various  inflammatory 
processes  or  neoformations. 

The  treatment  of  closure  of  the  lachrymal  canal  is  a  very  difficult  and 


Fig.  13S — Protrusion  of  the  membrana  nictitans. 

delicate  operation  to  handle.     It  consists  in  trying  to  establish  a  new 
opening  into  the  nasal  cavity  and  direct  the  tears  into  it. 

Diseases  of  the  Membrana  Nictitans. — Irritation  of  this  organ  may 
result  from  various  pathological  processes  which  affect  the  conjunctiva,  the 
membrana  nictitans  being  covered  on  both  surfaces  by  that  membrane. 


Fig,  139. — Removal  of  the  membrana  nictitans. 

Follicular  conjunctivitis  frcqviently  causes  the  formation  of  various  sized 
nodules  (hypertrophied  follicles)  round  bodies  about  the  size  of  a  millet 
seed,  deep  red  in  color,  and  may  sometimes  produce  a  tumor  which  is 
visible  in  the  internal  canthus  of  the  eye.  When  the  memlirane  is 
picked  up  and  examined  by  means  of  a  pair  of  forceps,  and  enlargement 
of  the  meml)rane  is  indicated  by  a  pink  red  tumor  in  the  internal  corner 
of  the  eye,  which  moves  over  the  eyes  on  slight  pressure  on  the  eyeball; 


INFLAMMATION  OF  THE  CONJUNCTIVA  401 

this  tumor  not  only  originates  from  follicular  conjunctivitis,  but  from 
traumatic  causes  and  neoformations  such  as  adenomas  of  Harder's  gland, 
lipomas  or  papillomas.  A  prolapse  of  the  membrane  without  any  hyper- 
trophy is  seen  frequentl}'  in  St.  Bernards,  retrievers  and  mastiffs,  when 
the  enlarged  membrane  lying  over  the  eye  gives  the  animal  a  sleepy  look- 
ing eye,  or  ''dead  eye"  (see  Fig.  138). 

Treatment. — Astringent  washes  of  boracic  acid,  zinc,  lead,  etc.,  may 
reduce  this  irritation,  but,  as  a  rule,  if  this  hypertrophic  condition  of  the 
membrana  nictitans  is  once  established,  removal  of  it  by  surgical  means 
is  the  only  way  to  establish  a  permanent  cure.  The  eye  is  first  treated 
by  a  few  drops  of  4  per  cent,  solution  of  cocaine,  and  then  the  enlarge- 
ment is  seized  by  a  pair  of  forceps  and  by  means  of  curved  scissors 
clipped  off  (Fig.  139).  Putting  a  thread  through  the  tumor  by  means 
of  a  curved  needle  enables  the  operator  to  make  a  much  evener  removal 
of  the  tumor  and  is  preferred  to  holding  it  with  forceps  by  some  operators. 
The  hemorrhage  is  insignificant  and  is  controlled  in  a  few  minutes.  If 
it  should  persist  for  some  time,  put  a  few  drops  of  acetate  of  lead  solu- 
tion on  the  eye  and  keep  the  lid  closed  for  a  few  moments  by  means 
of  a  pledget  of  cotton. 

DISEASES  OF  THE  CONJUNCTIVA. 

Inflammation  of  the  Conjunctiva — Conjunctivitis. 

{Co  nj  uncti  vitis;  Sy  ndcs  »!  it  is . ) 

Inflammatory  conditions  of  the  conjunctiva  are  the  most  frequent 
affections  of  the  eye  in  the  dog,  and  appear  in  various  ways  according 
to  their  cause.  Under  ordinary  circumstances  we  see  the  development 
of  a  simple  catarrh  of  the  conjunctiva,  which,  like  all  catarrhs  of  the 
mucous  membrane,  causes  swelling,  great  redness,  and  formation  of  loose 
folds  of  tissue.  The  redness  may  vary  from  a  slight  injection  to  a  dark 
or  bluish-red  coloration.  This  is,  as  a  rule,  regular  and  rarely  spotted 
with  blood  extravasations.  The  secretion  of  the  mucous  membrane  is 
sero-mucous  in  the  beginning,  but  later  on  becomes  muco-purulent,  and 
in  some  cases  there  is  a  peculiar  grayish  secretion.  This  secretion  becomes 
agglutinated  to  the  interstices  and  corners  of  the  eyelids,  producing  a 
gluing  together  of  the  lashes,  and  during  the  night,  when  the  animal  is 
asleep,  it  dries  up,  forming  a  grayish-yellow  adhesive  mass.  The  inflam- 
mation is  usually  restricted  to  the  conjunctiva  of  the  lid,  the  transition 
fold  and  the  bulb  of  the  conjunctiva  being  very  rarely  affected.  The 
follicles  of  the  connective  tissue  are  generally  swollen  in  all  prolonged 
forms  of  catarrh  of  the  eyes.     Sometimes  they  protrude  here  and  there 


402  DISEASES  OF  THE  EYES 

from  the  reddened  connective  tissue  in  the  shape  of  a  millet-seed  or  a 
sago  granule. 

In  cases  where  the  irritation  is  due  to  the  influence  of  some  infectious, 
pathological  microorganism  or  bacteria,  which  are  always  present  on 
the  conjunctival  membrane,  we  notice  a  marked  cellular  infiltration  of 
the  tissues  of  the  mucous  membrane,  with  proportional  swelling  of  the 
connective  tissue,  and  the  production  of  a  copious  thick,  yellowish-green 
secretion.  Under  the  influence  of  chemical  irritants  we  have  the  forma- 
tion of  grayish-white  or  transparent  membranous  accumulations  upon 
the  surface  of  the  mucous  membranes,  and  sometimes  ulcers  which  may 
lead  to  trichiasis  (turning  in  of  the  hair  of  the  lashes  toward  the  bulbs; 
the  mildest  form  of  entropion).  In  some  cases  it  may  cause  a  natural 
entropion  or  symblepharon  adherence  between  the  lid  and  bulbs  of  the 
conjunctiva.  The  cornea  and  the  conjunctiva  being  in  such  close 
proximity  to  each  other,  an  inflammatory  process  in  one  is  very  apt  to 
produce  a  similar  condition  in  the  other. 

The  following  forms  of  conjunctivitis  are  observed  in  the  dog: 

Catarrhal  Conjunctivitis  {Conjunctivitis  Simplex). — By  this  we  mean 
an  acute  catarrh  with  intense  redness  and  loosening  of  the  conjunctiva, 
also  copious  mucous  or  muco-purvdent  secretion.  The  local  disturbances 
do  not  seem  to  be  very  marked,  but  we  see  in  rare  cases  irritation  with 
itching,  the  patients  attempting  to  rub  their  eyes  with  their  paws. 

Etiology. — Catarrh  of  the  eyes  may  occur  at  any  period  of  the 
animal's  life,  and,  as  a  rule,  affects  both  eyes;  in  very  rare  instances  only 
one.  It  is  generally  the  result  of  exposure  to  cold  or  the  influence  of 
sharp,  cold  winds.  It  is,  .therefore,  apparent  why  it  appears  at  certain 
seasons  of  the  year  more  than  at  others,  that  is,  in  the  spring  and  fall. 
Mechanical  and  chemical  influences  also  produce  a  certain  effect,  such  as 
foreign  bodies  (dust,  hair,  etc.),  turning  in  of  the  eyelashes  (trichiasis), 
smoke  of  soft  coal,  etc. 

Catarrh  of  the  conjunctiva  is  intimately  connected  with  catarrh  of 
the  respiratory  organs,  such  as  nasal  catarrh,  distemper,  and  all  serious 
internal  diseases  which  have  a  prolonged  course. 

Symptoms  and  Course. — Pain  and  t^\4tchingof  the  eyelids,  which  is 
more  pronounced  if  foreign  Ijodies  are  present  in  the  conjunctival  mem- 
brane. In  the  early  stages  there  is  aslight  increase  of  the  flow  of  tears,  later 
it  becomes  mucous  and  finally  we  observe  a  muco-purulent  discharge 
which  is  very  tenacious  and  frequently  the  eyelids  stick  together,  the 
discharge  frequently  flowing  down  the  face,  and  the  conjunctival  mem- 
brane becomes  greatly  swollen  and  injected.  This  condition  may  become 
chronic,  lasting  in  a  modified  form  the  whole  course  of  the  animal's  life. 
Frequently  there  is  intense  itching,  causing  the  animal  to  continually 
scratch  the  affected  eyes  with  his  paws,  and  rub  them  on  the  ground,  pro- 


INFLAMMATIOy  OF  THE  CONJUNCTIVA  403 

diicing  consideral)le  increase  of  the  irritation  already  present.  When 
the  atiection  extends  to  the  cornea,  it  may  become  opaque,  and  in  more 
severe  cases  cause  uh-eration  of  the  cornea  (see  Keratitis). 

Conjunctivitis  follicularis  of  the  membrana  nictitans  is  a  variety  of 
this  disease  (catarrhal  conjunctivitis)  that  is  generally  chronic.  This 
is  indicated  by  the  appearance  of  large  numbers  of  lymphatic  follicles 
upon  the  internal  surface  of  the  membrana  mictitans.  These  follicles 
stand  out  distinctly  in  the  form  of  millet-seed  bodies  upon  the  surface 
of  the  meml^rane.  They  are  dark  red  and  transparent,  consisting  of 
ball-shaped  accumulations  of  lymphoid  cells.  Soon  they  appear  in 
numerous  masses,  giving  the  membrane  the  appearance  of  a  granulating 
M-ound  surface,  and  in  such  cases  the  membrana  nictitans  is  pushed  out 
from  the  bulbous  and  extended  over  the  cornea.  The  ciuestion  whether 
this  condition  is  a  form  of  follicular  conjunctivitis  or  it  is  to  be  accepted 
as  a  disease  sui  generis,  we  have  not  been  able  to  determine  fully,  but  we 
know  that  the  presence  of  numerous  lymphatic  follicles  prolongs  indefi- 
nitely the  course  of  a  case  of  conjunctivitis.  We  ought,  therefore,  to 
always  expose  the  membrana  nictitans  by  means  of  a  pair  of  forceps; 
evert  the  mem1)rane  and  examine  it  to  see  if  there  are  any  enlarged 
follicles,  or  a  foreign  bod}^  present,  especially  in  catarrh  of  the  conjunctival 
tissue.  According  to  Frohner,  40  per  cent,  of  all  dogs  are  affected  more 
or  less  by  conjunctivitis  follicularis. 

Purulent  Conjunctivitis;  Conjunctival  Blennorrhoea. 

Etiology. — It  is  generally  admitted  that  this  disease  is  due  to  a 
specific  infectious  organism  developed  in  the  course  of  some  epizootic 
disease,  particularly  distemper,  and  a  specific  form  of  this  disease  may 
occur  as  an  epidemic,  the  cause  of  which  up  to  the  present  time  has  not 
been  definitely  described.  It  is  possible  to  produce  the  same  form  of  the 
affection  by  inoculating  the  conjunctiva  of  a  healthy  dog  with  this 
purulent  material.  Guilmot  observed  that  by  placing  dogs  in  a  kennel 
which  had  been  previously  used  by  a  dog  affected  with,  this  disease  that 
they  soon  became  similarly  affected,  and  it  has  been  found  to  be  carried 
by  the  benches  where  dogs  are  exhibited.  Frohner  has  seen  it  in 
many  cases  of  distemper,  and  thinks  that  the  development  of  this  form 
of  conjunctivitis  is  due  in  all  probability  to  the  transmission  of  gonor- 
rhceal  secretion  from  a  human  being  placed  on  the  conjunctiva  of  the 
dog.  Guilmot  says  that  gonorrhoea!  secretion  of  the  dog  itself  is  the 
cause  of  this  disease,  but  this  assertion  is  combated  by  Moller  whose 
experiments  with  secretions  of  preputial  gonorrhoea  in  the  dog  have 
always  given  negative  results. 

This  form  of  conjunctivitis  is  marked  by  considerable  swelling  of 
the  membrane.     The  membrane  is  sometimes  spotted  red  b3'  hemorrhages; 


404  DISEASES  OF  THE  EYES 

there  is  sensitiveness  to  light,  and  jDhotopholjia,  the  animal  constantly 
winking  or  convulsively  closing  the  eye.  The  secretion  of  the  eye  is 
changed  into  a  muco-purulent  mass,  becoming  filled  with  a  thick, 
yellowish-green  fluid  mixed  with  pus,  which  agglutinates  the  lids,  partic- 
ularly during  the  night,  when  the  animal  is  asleep,  and  there  is  great 
itching  and  irritation  causing  the  animal  to  rub  the  eyes  continually 
with  his  paws,  and  in  this  condition  complications  of  the  cornea  are 
generally  present.  The  latter  becomes  cUdl  in  the  centre,  showing  ero- 
sions in  some  cases.  This  capacity  of  the  cornea  gradually  increases, 
becoming  darker,  more  opaque,  and  then  taking  a  yellowish-gray  colora- 
tion. We  may  see  in  some  cases,  ulceration  of  the  cornea  (see  Keratitis). 
A  common  occurrence  is  to  find  eczema  of  the  eyelid  and  the  skin  around 
the  eye. 

This  blennorrhoea  of  the  conjunctiva  is  a  rare  and  dangerous  disease, 
causing  extensive  inflammation  and  ulceration  of  the  cornea,  the  con- 
dition being  prolonged  in  some  cases  from  four  to  eight  weeks,  and  in 
extremely  bad  cases  the  eye  is  apt  to  be  destroyed. 

Therapeutic  Treatment  of  Conjunctivitis. — If  the  disease  is  produced 
by  foreign  bodies,  an  eruption,  etc.,  or  caused  by  trichiasis  or  entropion, 
we  have  to  remove  the  cause  first.  If  we  have  to  deal  with  dirt,  coal 
dust,  or  small  bodies,  it  is  sufficient  to  wash  out  the  eye  with  a  little  soft- 
rubber  syringe.  If  the  bodies  are  adherent,  such  as  iron  fragments, 
sand,  etc.,  accompanied  by  convulsive  movements  of  the  lids  and  intense 
secretion  of  tears,  we  must  apply  a  certain  amount  4  per  cent,  solution 
of  cocaine  to  the  eye,  remove  the  foreign  bodies,  or  wipe  them  off  by 
means  of  a  blunt  probe  or  sound  covered  by  a  handkerchief  or  cotton. 
Then  keep  the  animal  away  from  strong  light,  smoke,  etc. 

First,  foment  the  eye  thoroughly  with  boracic  acid  solution,  and  to 
thoroughly  clean  the  eye  the  membrana  nictitans  must  be  lifted,  as  that 
membrane  is  pulled  down  close  on  the  eye  as  soon  as  the  fomentation  is 
started;  the  eye  must,  however,  always  be  cocained  previous  to  doing 
this,  as  the  membrane  is  too  sensitive  to  do  it  otherwise.  The  cocaine 
solution  can  be  applied  by  means  of  an  atomizer. 

I^.       Cocaine  muriate,  0.25 

Aqua  distil,  5.0 

Sig. — A  few  drops  in  the  ej'e. 

I^.       Acoin,  0.1 

Aqua  distil,  10.0 

Sig. — A  few  drops  in  the  eye. 

In  catarrhal  conjunctivitis  we  must  use  astringents,  such  as  sulphate 
of  zinc,  sulphate  of  copper,  or  nitrate  of  silver.  These  solutions  must 
be  used  mild,  such  as  0.2  to  0.75  per  cent.  They  may  be  applied  by 
means  of  a  camel's  hair  pencil  or  atomizer  put  between  the  lids  and 


INFLAMMATION  OF   THE  CONJUNCTIVA  405 

washed  off  in  a  short  thiie  with  clean  water;  or  we  may  apply  nitrate  of 
silver,  following  it  up  a  few  minutes  afterward  with  a  2  per  cent,  solution 
of  chloride  of  sodium.  Alum  solutions  are  also  useful  for  washing  or 
painting  the  inflamed  membrane.  In  pronounced  photophobia  we  may 
paint  the  conjunctiva  with  a  solution  of  cocaine  or  tincture  of  opium  and 
gum  arabic.  In  chronic  cases  apply  ointments  of  calomel,  10  to  20  per 
cent.,  oxide  of  mercury,  3  to  5  per  cent.  It  is  not  well  to  keep  up  too 
long  with  one  preparation,  but  substitute  another  drug  after  a  certain 
period  has  elapsed. 

In  chronic  catarrh  of  the  eyes  a  very  effective  method  of  reducing 
the  irritation  is  to  blow  small  quantities  of  calomel  directly  on  the 
membrane.  Follicular  conjunctivitis  may  be  treated  with  astringents, 
but  in  the  acute  forms  which  occur  on  the  surface  of  the  membrana 
nictitans  we  can  only  remove  them  by  surgically  removing  the  membrane. 

]^.       Zinc  sulphate,  1.0 

Acid  boric,  3.0 

Aqua  distil.,  150.0 
Sig. — Eye  drops. 

I^.        Argenti  nitras,  0.1 

Aqua  distil.,  10.0 

Sig. — A  few  drops  in  the  eye  for  several  days. 

I^.        Hydrarg.  sesquioxide,  1.0 

Ung.  petrolati  4.0 

M.  F.  ung. 

Sig. — Apply  to  the  edges  of  the  lids  twice  daily. 

The  influence  of  cocaine  upon  the  conjunctiva  and  cornea  renders 
these  parts  insensitive  and  permits  a  number  of  small  operations  without 
producing  any  feeling  of  pain  or  convulsive  irritation  of  the  eyelid.  We 
pour  a  little  5  per  cent,  solution  of  cocaine  into  the  eye  and  obtain  in 
this  manner,  in  from  two  to  three  minutes,  an  absolute  insensibility  to 
pain,  both  in  the  cornea  and  conjunctiva.  This  does  not,  as  a  rule, 
last  more  than  ten  minutes  and  must  therefore  be  renewed  every  five 
minutes  if  necessary.  In  order  to  reduce  blepharospasm,  as  a  conse- 
quence of  conjunctivitis,  we  should  apply  s  lutions  of  cocaine  every  two 
or  three  hours.  In  the  milder  forms  of  follicular  conjunctivitis  that  is 
seen  on  the  inner  surface  of  the  membrana  nictitans,  the  stronger  solu- 
tions of  sulphate  of  zine,  sulphate  of  copper,  or  nitrate  of  silver  are  used. 
It  is  best  to  apply  a  solution  of  cocaine  to  the  eye  and  then  lift  up  the 
membrana  nictitans  and  apply  the  solution  directly  to  the  inside  sur- 
face of  the  membrane  by  means  of  a  camel 's  hair  brush.  These  cases 
are  generally  very  obstinate  to  treat  and  it  is  best,  when  after  some  time 
the  condition  does  not  improve,  that  the  membrana  nictitans  be  removed 


406  DISEASES  OF  THE  EYES 

by  surgical  means  (see  i)age  401).  This  operation  invarialjly  removes 
the  irritation. 

In  ophthalmic  blennorrhoea  we  must  endeavor  to  prevent  it  before 
it  goes  too  far,  particuhuiy  if  it  appears  as  an  epizootic.  We  must  treat 
it  with  antiseptic  agents,  and  it  is  especially  important  to  keep  the  con- 
junctiva clean  with  water  or  some  non-irritating  antiseptic  fluid,  such 
as  boric  acid,  3  per  cent.;  corrosive  sublimate,  0.02  per  cent.;  perman- 
ganate of  potassium,  0.05  per  cent.;  creolin,  1  per  cent.;  salicylic  acid, 
1  per  cent.;  carbo-sapo-cresol  or  lysol,  1  to  100.  These  must  be  intro- 
duced under  the  lid  l)y  means  of  a  syringe,  brush,  or  sponge.  "When  it  is 
necessary  we  must  irrigate  the  eye  with  strong  solutions  of  nitrate  of 
silver  (1  to  3  per  cent.) ,  taking  care  to  observe  the  rules  already  mentioned, 
that  is,  neutralizing  the  silver  solution  b}"  means  of  salt  solution.  A 
solution  of  itrol  1  to  4000  has  been  found  very  useful  in  these  cases. 
Covering  the  conjunctiva  with  calomel,  dermatol,  tannoform,  is  also 
useful.  This  is  applied  by  means  of  an  insufflator  or  blown  through  a 
cylinder  of  paper  or  a  c{uill.  Aniline  (pyoktanin),  advised  by  some 
authors,  is  of  little  benefit. 

The  treatment  may  also  be  materially  altered  ])y  complications  of 
the  cornea,  for  which  we  would  refer  to  Keratitis  for  further  details. 

Neoformations  on  the  Conjunctiva. 

Beside  the  inflammatory  condition  which  has  just  been  described, 
we  may  have  tumors,  fibromas,  papillomas  and  lipomas  of  the  conjunc- 
tiva, but,  as  a  rule,  these  occur  on  the  membrana  nictitans.  Thej^  are 
generally  painless,  sometimes  extending  over  the  eye  and  preventing  the 
closure  of  the  eyelids.  A  peculiar  case  of  hair  formation  has  been 
observed  by  the  writer,  situated  in  the  conjunctiva  of  the  upper  lid,  in 
which  a  tuft  of  long,  white,  silk-like  hair  grew  out  of  it,  and  a  few  isolated 
hairs  in  the  vicinity  of  the  spot.  On  examination  the  hair  spot  was  found 
to  contain  hair  Indbs,  sel)aceous  and  sudoriferous  glands.  It  was  found 
that  several  animals  of  the  same  strain  in  that  breed  had  similar  anomalies. 

DISEASES  OF  THE  CORNEA. 

Inflammation  of  the  Cornea. 

(Kcratiiis). 

Notwithstanding  the  fact  that  the  corneal  coat  does  not  contain 
any  blood  vessels,  it  is  frequently  the  seat  of  inflammatory  processes 
which  become  present  through  a  pericorneal  injection  due  to  intense 
irritation  of  the  blood  vessels  which  surround  the  border  of  the  cornea, 
and  further  by  an  opacity  of  the  cornea  forming  an  obstruction  that 
prevents  the  admission  of  rays  of  light  into  the  eye  itself.  This  clouding 
or  opacity  may  extend  over  the  entire  cornea,  or  it  may  only  involve  a 


DISEASES  OF  THE  CORNEA  407 

small  portion.  It  varies  in  color  from  a  grayish-blue  to  a  pure  gray.  It 
is  yellowish-gray  in  some  cases  (purulent  inflammation),  but  never 
pure  white  in  color.  On  careful  examination  it  seems  to  1)e  diffuse, 
forming  spots  or  stripes.  The  lustre  of  the  membrane  is  dull  on  its 
surface  and  a  partial  loss  of  the  epithelium  is  noticed.  The  other  symp- 
toms are  avoidance  of  light,  convulsive  movements  of  the  eyelids,  and 
discharge  of  a  thin  watery  mucus  from  the  corner  of  the  eyelids,  visual 
deficiencies,  and  in  some  cases  the  animarl  may  be  partially  or  even 
totally  blind.  This  is  especially  seen  when  the  opacity  of  the  sclerotic 
membrane  is  in  the  region  of  the  visual  line  that  is  opposite  the  pupil. 

Pathological  Anatomy. — We  have  in  other  cases  of  keratitis  the 
appearance  of  large  quantities  of  round  cells  in  the  corneal  tissue.  These 
come  from  the  blood  vessels  of  the  neighboring  membranes,  the  sclerotic 
membrane,  and  the  conjunctiva.  These  are  wandering  cells  which  find 
their  way  into  the  cornea.  As  long  as  the  round  cells  in  the  cornea  are 
not  crowded  together  it  remains  unaltered  in  its  true  structure  (in- 
filtration of  the  cornea),  and  complete  recovery  follows  after  the  cells 
have  disappeared.  But  as  soon  as  the  cells  are  packed  too  closely  to- 
gether the  corneal  tissue  is  partially  destroyed  by  maceration  and  ne- 
crosis, followed  by  a  loss  of  actual  substance.  If  this  is  surrounded  by 
intact  tissue  of  the  cornea,  it  forms  an  abscess;  if  it  is  open  externally, 
it  forms  an  ulcer.  We  consider  as  ulcers,  small  superficial  openings  in 
the  cornea  which  are  always  round  in  the  early  stages,  and  are  caused 
by  infiltrations  located  closely  under  the  epithelium,  forming  little 
blisters  or  sacs,  and  finally  bursting  through  the  epithelial  covering. 
In  the  dog,  as  a  rule,  they  heal  without  leaving  any  cicatrix.  Still, 
many  cases  are  seen  where  they  finally  close  up,  leaving  a  white  cicatrix, 
or  else  they  lead  to  perforation  of  the  cornea  or  to  a  total  destruction 
of  the  eye  by  extending  into  the  anterior  chamber. 

We  find  the  following  forms  of  inflammation  of  the  cornea: 

(1)  Keratitis  Super ficialis. — Etiology. — Superficial  inflammation  of 
the  sclerotic  membrane  is  caused  by  slight  irritations  of  various  kinds 
(superficial  injuries,  inversion  of  the  eye-lashes  (trichiasis)  or  entropion). 
It  may  also  originate,  secondarily,  from  acute  conjunctivitis,  the  in- 
flammation extending  from  the  conjunctiva  to  the  cornea,  irritating 
eye  washes  or  salves,  or  from  foreign  bodies.  Keratitis  superficialis 
may  also  appear  as  a  secondary  symptom  of  distemper,  but  generally 
in  this  case  the  entire  parenchyma  is  involved. 

The  cornea  is  clouded,  opaque  and  lustreless,  having  a  diffuse 
grayish-blue  or  grayish-white  coloration,  with  a  slightly  irregular  surface, 
but  under  certain  circumstances  it  may  also  be  covered  with  small 
epithelial  masses,  easily  distinguished  with  the  naked  eye.  In  this 
affection   the   eyes   are  watery,   which   may   disappear  in  a  few  days 


408  DISEASES  OF  THE  EYES 

or  last  for  weeks.  In  the  latter  case  we  observe  the  formation  of  blood 
vessels  at  the  border  of  the  cornea  and  the  sclerotic  membrane.  These 
blood  vessels  increase  in  size  and  the  edges  become  very  vascular,  and 
during  vascularization  of  the  cornea  it  is  not  rare  to  see  hemorrhages 
in  that  tissue  followed  by  a  number  of  brownish-black  pigment  spots, 
and  occasionally  the  cornea  remains  permanently  opaque  and  even 
vascular.  Froehner  describes  a  superficial  purulent  affection  of  the 
cornea  as  an  effect  of  purulent  keratitis  or  as  a  secondary  symptom  of 
distemper;  this  is  indicated  by  a  roughened  appearance  of  the  cornea, 
and  a  yellowish  opacity  of  the  cornea  due  to  pus  corpuscles. 

Therapeutics. — The  treatment  is  the  same  as  in  inflammation  of 
the  conjunctiva — that  is,  washing  and  painting  with  a  solution  of  sul- 
phate of  zinc,  corrosive  sublimate,  alum,  or  sulphate  of  copper,  boracic 
acid,  or  the  oxide  of  mercury  salve;  where  there  is  great  pain  and  photo- 
phobia use  solutions  of  cocaine  or  acoin.  Avoid  all  use  of  lead  solutions 
in  such  cases  where  there  is  any  loss  of  substance  of  the  cornea,  as  the 
lead  is  deposited  in  the  ulcer  and  produces  black-colored  spots  which  are 
permanent.  If  there  is  any  ulceration,  we  must  apply  the  therapeutic 
treatment  as  indicated  in  ulcerative  keratitis,  and  in  cases  where  the 
spots  on  the  cornea  remain  use  the  treatment  given  under  the  same 
heading. 

Peritomy. — This  operation  is  recommended  in  pannus,  that  con- 
dition where  there  is  vascularization  of  the  cornea,  and  after  massage, 
stimulating  salves  and  hot-water  compresses  have  been  tried  and  failed. 
The  animal  must  have  a  few  drops  of  a  4  per  cent,  solution  of  cocaine 
put  into  the  eye,  and  the  lids  held  back  by  an  assistant;  then  the  affected 
surface  of  the  cornea  is  carefully  scarified,  or  curetted  by  means  of  the 
edge  of  a  sharp  knife.  Great  care  must  be  taken  to  hold  the  knife  at  right 
angles  to  the  eye,  as  the  slightest  slip  or  struggle  on  the  part  of  the  animal 
misplacing  the  position  of  the  knife  will  cut  through  the  cornea.  The 
surface  must  be  carefully  scraped  until  all  of  the  vessels  are  removed  from 
the  surface  of  the  cornea.  Frick  recommended  making  a  direct  incision 
in  the  cornea.  He  fixes  the  eye  and  by  means  of  a  very  sharp  knife,  pares 
off  the  aljnormal  formation,  even  cutting  down  half  through  the  body  of 
the  cornea,  treats  it  with  boric  acid  solution,  and  generally  has  a  cure 
in  a  few  days. 

(2)  Keratitis  Profunda  or  Keratitis  Parenchymatosa.  Deep  Paren- 
chymatous Inflammation  of  the  Cornea. — This  affection  may  be  circum- 
sicribed  or  diffuse.  In  the  former  it  is  due  to  some  external  traumatism 
directly  on  the  corneal  membrane;  in  the  latter,  the  diffuse  condition  is 
due  to  some  infectious  disease  such  as  distemper,  or,  in  certain  cases, 
fever  is  the  only  other  symptom  present.  The  surface  of  the  cornea 
has  an  opaque,  dull,  slightly  grooved  condition,  the  color  bluish-gray 


DISEASES  OF  THE  CORNEA  409 

or  gray,  rarely  grayish-white,  either  covering  the  entire  cornea  or  only 
certain  portions,  accompanied  by  watery  eyes,  sensitiveness  to  light 
(but  only  to  a  slight  degree),  and  also  the  formation  of  new  vessels 
which  extend  from  the  borders  of  the  cornea  toward  the  centre.  In  the 
keratitis  of  distemper  the  opacity  covers  the  entire  eye,  and  is  blue-gray 
or  even  milky  in  color.  Abscesses  and  ulcerations,  as  a  rule,  are  rare. 
This  form,  however,  must  not  be  mistaken  for  ulcerative  keratitis.  In 
mild  cases  the  opacity  may  disappear  without  leaving  any  trace;  in 
more  severe  cases  it  may  run  a  protracted  course,  with  vascular  infiltra- 
tion from  the  border  of  the  cornea.  These  cases  are  very  difficult  to 
treat,  running  on  sometimes  for  months  and  at  times  resist  all  forms 
of  treatment,  in  some  cases  terminating  in  ulceration  (see  Keratitis). 

The  course  of  this  disease  is  generally  favorable.  After  several 
weeks  the  dulness  disappears  and  the  new  vessels  become  thinner,  dis- 
appearing entirely  in  a  short  time. 

Therapeutics. — We  attempt  to  remove  the  irritation  to  a  certain 
extent  by  applications  of  compresses.  Also  irrigate  with  warm  w^ater  or 
boric  acid,  and  drop  atropia  into  the  eyes.  Bandages  over  the  eyes. 
If  the  inflammatory  symptoms  are  reduced,  we  then  follow  it  up  by 
stimulant  irritants,  such  as  calomel  powder  or  ointments  of  red  oxide 
of  mercury.  As  to  massage  of  the  cornea  and  treatment  of  ulceration  see 
Keratitis. 

(3)  Abscesses  of  the  Cornea. — Etiology. — Abscesses  of  the  cornea 
appear  after  some  traumatism,  especially  contusions  or  bruises  of  the 
membrane,  also  after  non-septic  operations,  in  connection  with  blennor- 
rhoea  or  conjunctivitis,  or  during  distemper,  and  very  frequently  appear 
without  any  appreciable  cause,  which  some  ascribe  to  lymphatic  in- 
fection. 

When  there  is  intense  dread  of  light  and  great  increase  of  tears, 
and  when  we  see  a  pericorneal  injection  and  the  cornea  colored  a  gray, 
yellow,  or  straw-yellow,  and  a  certain  spot  on  that  part  which  is  sharply 
defined  from  the  tissue  of  the  normal  cornea,  or  it  is  surrounded  by  a 
more  or  less  dull  zone,  we  then  can  safely  conclude  that  it  is  the  com- 
mencing formation  of  an  abscess.  Its  location  varies;  sometimes  it  is 
on  the  edge  of  the  cornea,  at  other  times  in  its  centre;  then,  again,  we 
may  find  it  close  to  the  surface  of  the  membrane  or  deep  in  the  centre  of  it. 
It  may  be  very  small  in  dimension,  such  as  the  size  of  a  pin-head,  or  it 
may  even  include  the  whole  sclerotic  membrane. 

The  course  varies  also.  In  small  abscesses  it  may  disappear  by 
simple  absorption,  while  in  large  ones  the  acute  inflammation  subsides, 
frequently  leaving  an  intensely  white  spot,  or  it  may  break  out  exter- 
nally, forming  an  open  ulcer.  This  latter  conclusion,  or  termination,  is  the 
most  common,  and  in  rare  instances  it  may  break  in  a  posterior  direction 


410  DISEASES  OF  THE  EYES 

toward  the  anterior  chamlier  of  the  eye,  causing  an  accumulation  of  pus 
in  it  (hypopyon)  and  producing  further  infiammatoiy  processes  in  the 
internal  part  of  the  eyeball. 

Therapeutics. — This  is  closely  related  to  that  of  ulcerations  of  the 
cornea — that  is,  to  open,  puncture,  or  cauterize  the  abscess  after  first 
using  cocaine  in  the  cornea.  It  is  then  dried  with  corrosive  suljlimate 
or  iodoform  gauze  antl  washed  out  with  a  solution  of  corrosive  subli- 
mate, and  afterwards  dusted  with  calomel  until  it  dries  up;  in  certain 
cases  touching  the  edges  with  the  actual  cautery  seems  to  bring  about 
jjrompter  resolution. 

(4)  Ulceration  of  the  Cornea. — Ulcus  Comeae. — This  results  from 
traumatisms,  irritations,  and  an  accompaniment  of  distemper;  it  also 
appears  in  diabetes  mellitus  and  certain  breeds,  such  as  toy  spaniels  and 
Boston  terriers,  seem  to  be  prone  to  it,  with  no  appreciable  cause;  ap- 
parently it  is  due  to  a  certain  cachexia  and  after  maceration  or  necrosis 
of  the  corneal  epithelium,  as  a  consequence  of  blennorrhoea  of  the  cornea. 
In  this  condition  we  find  a  loss  of  substance  in  the  cornea  which  vaiies 
in  size  and  depth,  showing  a  grayish-white  or  grayish-yellow  ground,  and, 
as  a  rule,  has  short,  abrupt  liorders  with  a  bluish-gray,  gray,  or  grayish- 
yellow  opacity  in  the  immediate  neighborhood  of  the  ulceration  and 
accompanied  by  great  dread  of  light;  the  eyelids  are  practically  closed 
and  the  membrana  nictitans  drawn  over  the  eye.  "When  the  ulceration 
of  the  cornea  begins  to  heal  it  is  indicated  by  a  lessening  of  the  infiltra- 
tion in  the  immediate  neighborhood  of  the  ulcer,  the  dull  circle  sur- 
rounding it  becomes  clearer,  the  pericorneal  injection  less,  and  the 
dread  of  light  begins  to  disappear.  In  rare  instances  blood  vessels 
will  shoot  from  the  edge  of  the  cornea  toward  the  ulcer,  and  the  cornea 
in  appearance  very  much  resembles  the  normal  tissue  of  the  sclerotic 
membrane.  If  the  ulceration  has  not  been  veiy  deep,  the  dulness 
gradually  disappears,  leaving  only  a  very  thin  white  veil  of  opacity;  or, 
if  the  ulceration  is  deep,  we  have  as  a  result  a  distinct  white  spot  which 
remains  permanently  (cicatrix  of  the  sclerotic  membrane,  macula  cornea). 
This  cicatrix  of  the  membrane  may  become  clearer  in  the  course  of  time, 
but,  as  a  rule,  it  never  disappears  entirely.  AMien  the  ulcer  does  not 
take  a  favorable  termination  we  find  the  inflammation  increases,  the 
ulceration  becomes  deeper,  reaches  the  membrane  of  Descemet,  and  we 
have  a  perforation  of  the  meml)rane  in  a  few  days.  The  contents  of  the 
anterior  chamber  escape  through  the  opening,  and  in  rare  instances 
the  iris  and  the  lens  push  forward  and  maj'  also  protrude  if  the  opening 
is  large  enough.  After  jiorforation  occurs  the  ulcer  begins  to  heal,  and 
we  are  very  apt  to  have  an  adhesion  of  the  iris  and  lens  to  the  posterior 
wall  of  the  corneal  membrane,  the  pupil  is  drawn  to  the  edge  of  the 
cicatrix  and  the  sight  greatly  impaired.     In  othei-  cases  where  the  opening 


DISEASES  OF  THE  CORNEA  411 

of  the  ulcer  is  very  small  the  anterior  chamber  fills  up  again,  is  forced 
forward,  forming  a  clear  bladder-like  body,  forming  corneal  prolapse  or 
dropsy  of  the  cornea  (keratocele).  If  the  ulcer  is  large,  the  membrane  of 
Descemet  pushes  throvigh  the  ulcer  from  internal  pressure  and  the  whole 
ground  of  the  ulcer  becomes  embossed — that  is,  it  stands  out  from  the 
surrounding  membrane.  As  a  consequence  of  perforation  of  the  cornea 
we  may  have  a  series  of  alterations  to  the  iris.  Externally  the  iris, 
which  is  drawn  into  the  orifice,  becomes  covered  with  cicatricial  tissue, 
and  by  its  contraction  forms  a  lobule  of  the  iris.  This  finally  contracts 
into  a  peculiar  club-shaped  body  over  the  anterior  surface  of  the  mem- 
brane (iris  staphyloma),  ^^'e  must  not  confound  this  condition  with 
staphyloma  pellucidum,  by  which  we  mean  a  change  of  form  in  the 
corneal  membrane,  due  to  a  non-inflammatory  condition,  where 
it  becomes  more  or  less  opaque  and  is  forced  outward  in  the  shape  of  a 
grape-like  body  by  the  dropsical  condition  of  the  anterior  chamber. 
"When  there  is  great  irritation  of  the  corneal  membrane,  in  some  cases 
we  ma}'  have  a  prolapsus  of  the  lens,  and  the  whole  eye]:)all  subsequently 
collapses,  forming  an  opening  in  the  centre  of  the  eye  which  finally 
becomes  closed  up  by  a  whitish-gray  cicatrix. 

Besides  the  causes  alread}'  mentioned  in  the  formation  of  abscesses, 
the  following  also  produce  them:  cauterization,  foreign  bodies  which 
adhere  to  the  membrane,  wounds  in  some  cases,  etc.  This  disease 
may  appear  in  the  epizootic  form  with  or  without  distemper,  and  gen- 
erally in  connection  with  blcnnorrhoea  of  the  whole  eyeball  (purulent 
panophthalmitis) . 

Prognosis  and  Therapeutic  Treatment, — The  prognosis  depends  to  a 
large  extent  on  the  irritation  of  the  ulcer  and  the  rapidity  of  its  progress. 
Ulcers  which  are  small  and  located  on  the  borders  are  easier  to  treat 
than  those  which  are  larger  and  located  in  the  centre  of  the  cornea.  In 
weak,  badly  fed  young  animals  and  in  pugs  the  prognosis  is  more  un- 
favorable than  in  healthy  adult  animals. 

The  treatment  requires  cleanliness  and  strict  antiseptic  remedies. 
The  use  of  a  dressing  is  of  great  advantage,  but  few  dogs  can  be  made  to 
submit  to  one.  In  canine  hospitals,  as  a  rule,  they  use  a  specially 
constructed  leather  cap;  it  is  not  to  be  used  except  in  extreme  cases, 
where  it  is  impossible  to  keep  the  animal  from  scratching  or  rubbing  the 
eye.  It  is  always  well  to  leave  the  affected  eye  without  covering,  as  all 
bandages  or  covei'ings  are  apt  to  press  on  the  eye  and  cause  intense 
pain,  which  irritation  the  animal  generally  increases  by  rubbing  or  pulling 
constantly  at  the  covering.  The  various  antiseptic  agents  which  are 
used  are  corrosive  sublimate,  1  to  2000,  or  chlorine  water  (either  pure  or 
mixed  with  two  or  three  parts  of  water),  to  be  applied  with  a  brush  and 
calomel  powder  blown  from  a  ciuill  directly  on  the  eye.     The  writer  has 


412  DISEASES  OF  THE  EYES 

obtained  very  satisfactory  results  with  hot  fomentations  of  boric  acid 
(3  parts  to  100).  These  shoukl  be  applied  three  times  daily,  ten  minutes 
at  a  time.  They  are  far  better  than  cauterizations  with  nitrate  of  silver 
or  painting  with  pyoktanin. 

Besides  the  antiseptic  treatment  we  can  use  atropine  or  eserine 
solution,  of  which  a  few  drops  are  put  in  the  eye.  The  first-named 
agent  should  be  applied  when  the  ulcer  is  located  centrally,  as  it  dilates 
the  iris,  and  consecjuently  the  pupil  is  enlarged,  and  the  latter  when 
the  ulceration  is  located  on  the  borders  as  it  contracts  the  pupil  and 
draws  it  away  from  the  seat  of  irritation.  There  is  an  objection  to 
atropine  in  that  it  increases  the  internal  pressure  by  widely  dilating  the 
pupil.  The  iris  is  dilated  or  contracted  by  these  drugs  and  removed 
from  the  neighl^orhood  of  the  ulcer,  so  that  if  the  perforation  does  not 
occur  the  iris  will  be  drawn  far  enough  out  of  the  road  to  prevent  any 
adhesion. 

Good  results  have  been  obtained  with  cocaine,  alternating  with 
atropine : 

J\.       Atropine  sulphate,  0.1 

Aqua  distil.,  10.0 

M.  S.  In  order  to  produce  a  dilatation  of  the  pupil  we 
must  introduce  five  drops  of  this  remedy  into  the 
conjunctiva,  drop  by  drop,  by  means  of  a  brush  or  a 
dropper. 

I}.       Eserine  salicylate,  0.05 

Aqua  distil.,  10.0 

When  a  keratocele  is  developed  we  may  prevent  rupture  by  punc- 
turing the  membrane  with  a  needle  and  allowing  the  water  in  the  chamber 
to  escape.  In  prolapsus  and  adhesion  of  the  iris  we  can  do  very  little, 
as  it  is  impossible  to  push  back  the  iris  into  place.  We  must  dust  the 
protruded  portion  with  calomel;  at  the  same  time  we  may  reduce  the 
enlargement  by  means  of  nitrate  of  silver  or  sulphate  of  copper  solutions, 
or  a  powder  of  oxide  of  mercury  blown  on  the  eyeball.  In  iris  staphy- 
loma, where  the  tissue  does  not  wedge  and  contain  a  portion  of  the  con- 
tents of  the  anterior  chamber,  the  eye  may  be  cocained  and  by  means 
of  a  very  sharp  pair  of  scissors  the  staphyloma  may  be  carefully  cut 
down;  if,  however,  the  protruded  portion  is  filled  with  the  fluid  portion 
of  the  anterior  chamlier,  a  threaded  needle  is  carried  through  the  centre 
of  the  protruded  portion  and  the  thread  cut  at  the  needle  and  thus 
making  two  ligatures  which  are  tied  right  and  left  dividing  the  enlarge- 
ment into  two  poi'tions,  the  ligatcd  portion  of  the  cornea  will  dry  and  pull 
off  in  a  few  days  with  the  ligatures,  leaving  a  surface  which  dries  up  very 
quickly  with  the  ordinary  antiseptic  treatment. 


DISEASES  OF  THE  CORNEA  413 

"We  must  try  to  remove  any  spots  on  the  sclerotic  membrane  l)y 
means  of  irritants,  such  as  the  mihl  chloride  or  oxide  of  mercury  or 
massage.  According  to  Bayer,  massage  of  the  cornea  has  to  be  per- 
formed in  the  following  manner:  The  points  of  the  fingers  are  placed  on 
the  closed-up  eyelids  and  by  a  constant  circular  or  centrifugal  friction 
move  the  eyelid  for  sometime.  In  some  cases  we  may  also  apply  the 
above-mentioned  ointments  and  powders.  The  writer  has  obtained 
far  the  liest  results  from  calomel  than  anything  else.  He  placed  daily 
a  small  amount  of  powder  composed  of  equal  parts  of  calomel  and  sugar 
(grape  sugar)  on  the  cornea  and  massaged  the  eyelid  for  ten  minutes. 
Very  good  results  by  painting  the  enlargement  several  times  daily  with  a 
solution  of  pyoktanin  (1  to  100). 

The  following  alterations  are  also  seen  in  the  cornea  of  the  dog: 
Dermoid    of    the    Cornea. — This    condition    has    already    been    de- 
scribed   under    neoformation   of   the    cornea.     We    find  a  peculiar  ab- 
normal collection  of  true  epidermal  tissue  on  the  cornea  Avhich  is  covered 
with  hair  and  interferes  with  the  direct  action  of  light,  and  also  produces 


Fig.  140. — Dermoid  of  cornea. 

irritation  in  the  cornea  and  conjunctiva  (Fig.  140).  The  hair  should 
be  cut  off  by  means  of  scissors.  Thierry  observed  the  same  a]3normality 
on  the  sclerotic  membrane  of  both  eyes  in  a  three  months'  old  dog. 
There  was  a  slight  swelling  and  enlargement  above  the  surface  of  the 
membrane  which  was  covered  with  fine  hair. 

The  treatment  consists  in  the  removal  of  the  almormality,  the  eye 
is  cocained,  the  dermoid  is  lifted  with  a  pair  of  fine  curved  forceps  and 
removed  by  means  of  a  pair  of  curved  scissors.  An  opacity  of  the  cornea 
follows  as  a  result;  no  attempt  should  be  made  to  remove  this  for  at 
least  two  months,  as  any  friction  or  manipulation  shortly  after  the 
operation  is  apt  to  set  up  great  irritation.  In  removing  the  dermoid 
great  care  must  be  exercised  not  to  cut  entirely  through  the  cornea  and 
allow  the  escape  of  the  contents  of  the  anterior  chamber;  if  any  part  of 
the  dermoid  seems  to  involve  the  deep  structure  of  the  cornea,  it  had 
better  be  left  alone.     French  advises  that  during  the  operation  a  stream 


414  DISEASES  OF  THE  EYES 

of  -u-arm  water  should  run  over  the  eye  to  carry  off  the  blood  and 
facilitate  the  operation. 

Pterygium. — By  this  we  mean  a  more  or  less  triangular  proliferation 
of  the  connective  tissues  containing  numerous  blood  vessels  and  branching 
over  the  cornea  toward  the  centre.  This  growth  is  very  loosely  connected 
with  the  corneal  structure  and  can  be  removed  by  means  of  caustics  or 
by  an  operation;  the  animal  is  narcotized  or  the  eye  cocained,  the  growth 
seized  by  means  of  a  pair  of  curved  forceps,  raised  from  the  surface  of  the 
globe,  and  carefully  dissected  out,  and  the  hemorrhage  controlled  by 
astringents. 

Injuries  to  the  Cornea. — It  is  not  uncommon  to  observe  injuries  to 
the  cornea  of  dogs  where  the  epithelium  is  slightly  injuried  or  where  there 
is  a  deep  penetration  of  the  membrane  or  it  is  entirely  perforated,  such 
as  injuries  from  cats'  claws  or  sticks  mischievously  pushed  into  the  eye 
or  from  the  lash  of  a  whip.  Immediately  after  the  injury  we  observe  a 
great  fear  of  light,  closing  of  the  eye,  and  copious  tears.  Wounds  which 
have  not  entirely  perforated  the  cornea  are  rapidly  followed  by  an 
opacity  and  swelling  in  the  neighborhood  of  the  injury.  When  the 
membrane  is  perforated  the  symptoms  and  results  are  very  similar  to 
ulceration.  Superficial  or  very  small  wounds  which  penetrate  deeply 
heal  ver}'  quickly  after  a  few  days,  leaving  scarcely  any  opacity.  This, 
of  course,  must  be  expected  in  wounds  that  have  been  caused  by  some 
object  that  was  clean,  while  septic  large  wounds,  caused  by  some  unclean 
object,  frequently  produce  great  irritation,  and  penetrating  ulceration 
results,  ending  in  panophthalmia  and  destruction  of  the  eye. 

The  therapeutic  treatment  of  wounds  of  the  cornea  is  identical 
with  that  of  corneal  ulceration. 

Desiccative  Keratitis.  Xerosis  Corneae. — This  is  a  particularly  rare 
condition  described  by  Bayer  that  occurs  as  a  result  of  acute  distemper; 
it  is  seen  particularly  in  pugs.  The  animal  has  a  wide  open  staring 
look  of  the  eye,  the  cornea  is  dull  and  lustreless,  there  being  no  reflection 
in  it;  the  conjvmctiva  is  tumefied,  corrugated  and  deep  purple-red  in  color 
and  covered  with  a  thick  tenacious  secretion.  After  a  short  time  the 
cornea  commences  to  slough  small  portions  of  its  substance,  and  it 
finally  becomes  reddish-brown  in  color.  The  treatment  consists  in 
moist  fomentations  and  compresses  of  boracic  acid  solution,  followed 
by  astringents  such  as  acetate  of  lead  or  sulphate  of  zinc  solutions. 
If  the  acute  symptoms  of  distemper  have  not  shown  themselves  they 
are  apt  to  appeal-  shortly  after  this  condition  is  developed. 

Corneal  Spots  or  Opacities.  Maculae  Corneae.  Leucoma. — By  this 
is  meant  more  or  less  turbidity  or  opacity  of  the  cornea,  due  to  injuries, 
ulcerative  keratitis  and  certain  opacities  that  are  not  accompanied  by 
fever    or    other    phenomena.     These    spots    may    vary    from  complete 


DISEASES  OF   THE  CORNEA 


415 


opacity  of  the  cornea  to  cloud-like  spots,  dull  white,  chalky  white, 
or  pigmented  (Fig.  141).  Calomel  blown  on  the  cornea  by  means 
of  a  small  cylinder  of  paper  or  a  quill,  salves,  such  as  calomel 
1  part  and  petroleum  salve  4  parts;  a  piece  the  size  of  a  pea  is  put 
on  the  cornea  and  the  lid  gently  massaged  for  several  minutes.  Calo- 
mel and  sugar  of  milk,  equal  parts,  is  also  used;  a  small  portion  is  put  on 
the  eye  by  means  of  a  camel's  hair  pencil,  and  the  lid  is  gently  massaged, 
moving  the  lid  by  a  circular  motion  of  the  finger  for  ten  or  fifteen  minutes. 
Red  and  yellow  precipitate  of  mercury  ointment  or  a  few  drops  of  iodide 
of  potassium,  3  per  cent,  solution,  are  sometimes  found  useful  as  an  ab- 
sorbent. When  there  are  elevations  or  encrustations  on  the  cornea  due 
to  the  deposit  of  chemicals  from  eye  washes,  they  can  be  curetted 
(scraped)  off  by  means  of  a  sharp  knife.    The  cornea  is,  as  a  result  of  this 


Fig.   141. — Leucoma. 


irritation,  apt  to  be  slightly  denser  in  its  structure.  Certain  permanent 
opacities  of  the  cornea  that  disfigure  the  animal  can  be  modified  by 
means  of  tattooing;  the  eye  is  cocained  and  a  tattooing  needle  used. 
The  punctures  are  made  in  an  oblique  direction  to  avoid  any  possibility 
of  puncturing  the  cornea;  a  great  number  of  small  punctures  are  made 
in  the  body  of  the  opacity,  covering  its  entire  surface,  and  sepia  or  india 
ink  rubbed  into  punctures.  This  is  done  by  putting  the  color  in  solution 
on  the  eye  and  massaging  the  lid  for  ten  or  fifteen  minutes  at  a  time. 
This  tattooing  may  have  to  be  repeated  several  times. 


416  DISEASES  OF  THE  EYES 

DISEASES  OF  THE  CRYSTALLINE  LENS. 
Cataract. 

All  diseases  of  the  lens,  either  of  its  membranes  or  its  capsule,  as  a 
rule  cause  a  certain  amount  of  opacity,  and  may  form  one  or  more  star- 
like gray  bodies  in  the  centre  of  the  lens  itself  (cataract).  It  is  not 
possible  to  enter  into  a  description  of  the  various  forms  of  cataract 
and  its  pathological  alterations,  but  we  will  only  take  up  one  form  (gray) 
of  cataract  that  can  be  subdivided  into  two  forms — soft,  which  may 
be  congenital;  or  traumatic  and  hard  or  contracted  cataract,  which  is 
senile.  The  softening  process  generally  begins  in  the  equator  of  the 
lens,  and  becoming  diffused  soon  causes  a  total  opacity  of  light  gray 
color.  This  may  be  streaked  with  darker  lines  or  it  may  have  a  mother- 
of-pearl  discoloration,  with  enlargement  or  distortion  of  the  lens  and  a 
contraction  of  the  anterior  chamber.  This  is  very  often  seen  in  young 
animals.  The  contracting  process,  on  the  contrary,  begins  in  the  shape 
of  a  number  of  small  whitish  striae,  or  dull  opacities,  in  the  peripheric 
layers  of  the  lenticular  nucleus,  and  extend  gradually  over  the  cortical, 
giving  the  lens  a  yellowish-white  or  yellow  aspect  after  some  time. 
This  is  generahy  observed  in  old  dogs  (hard  nuclear  cataract,  senile 
cataract).  The  so-called  capsular  cataract  does  not,  as  a  rule,  depend 
on  true  opacity  of  the  capsule,  but  on  an  accumulation  of  proilucts 
of  the  same,  which  have  been  developed  from  disease  processes  which 
have  gone  on  in  its  immediate  neighborhood.  For  instance,  the  in- 
flammation of  the  iris.  In  some  cases  they  appear  in  small,  star-like 
or  streaked  pigmented  dull  spots,  which  are  distinctly  marked. 

Etiology. — Gray  cataract,  as  a  rule,  is  a  senile  or  old-age  affection, 
but  it  appears  Ciuite  frequently  in  young  dogs;  in  this  case  the  opacity 
is  deep-seated,  and  brilliantly  white  star-like  opacities  appear  in  the  poste- 
rior part  of  the  lens,  and  now  and  then  it  is  congenital.  The  writer  saw  one 
case  of  hereditary  star  cataract  in  connection  with  microphthalmus. 
Meleval  observed  in  the  progeny  of  a  pair  of  poodles,  where  the  dog  had 
a  double  cataract,  that  the  pups  had  lenticular  opacities.  The  develop- 
ment of  cataract  which  occurs  in  advanced  age — that  is  to  say,  after 
ten  or  twelve  years — is  what  is  known  as  senile  cataract;  this  is  slow  in 
its  development,  while  cases  of  opacity  of  the  lens,  which  are  observed  in 
young  animals,  appear  frequently  without  any  marked  cause,  and  run 
their  course  very  rapidly,  the  opacity  forming  in  a  few  weeks,  and  even 
in  a  few  days  the  wliole  lens  has  been  completely  covered.  Traces  of 
sugar  are  found  in  the  urine  of  dogs  which  become  very  thin  and  anaemic 
in  a  short  time,  cataract  frequently  developing  in  this  condition.  Frohner 
thinks  that  the  lens  becomes  saturated  with  grape-sugar,  which  is  present 


DISEASES  OF  THE  CRYSTALLINE  LENS  417 

in  diabetes,  and  the  lens  undergoes  a  retrogressive  metamorphosis  due 
to  disturbance  of  its  nutrition. 

There  is  no  doubt  that  cataract  is  also  caused  by  inflammatory- 
processes  of  the  eye,  and  the  nutritive  supply  of  the  lens  becomes  dis- 
turbed and  its  normal  condition  impaired,  such  as  ulcerations  of  the 
cornea  with  central  perforation,  inflammation  of  the  meml^rane  of  the 
lens  and  iris,  and  also  bleeding  into  the  anterior  chamber.  Injuries 
of  the  lens  and  concussions  of  the  eye  also  cause  a  number  of  cases  of 
cataract. 

Certain  conditions  are  developed  as  the  result  of  concussion  of  the 
eye  and  appear  quite  frequently;  they  may  be  thus  briefly  described: 
The  lens  either  sinks  downward  with  the  capsule  or  becomes  laterally 
displaced.  It  may  lean  against  the  iris  or  it  may  drop  forward  into 
the  anterior  chamber  of  the  eye,  and  it  may  finally  crowd  into  the 


Fig.   142. — Gray  cataract  of  both  eyes. 


vitreous  humor.  If  the  lens  has  undergone  but  slight  displacement 
(subluxation),  it  may  remain  clear  for  some  time,  but  the  vision  is 
much  impaired.  If  it  has  fallen  into  the  anterior  chamber  or  has  been 
forced  into  the  vitreous  humor,  we  see  a  rapid  development  of  the 
cataract,  and  in  the  later  stages  considerable  inflammation  of  the  choroid 
membrane  of  the  iris,  or  of  the  whole  eyeball. 

Clinical  Symptoms. — In  cases  where  the  disease  is  somewhat  ad- 
vanced, and  the  cataract  is  fully  developed  into  one  of  the  following 
forms — punctiform,  streaked,  spotted,  or  complete  opacity  of  a  whitish- 
blue,  brownish-blue,  or  mother-of-pearl  color — it  is  easily  recognized 
(Fig.  142) ;  but,  on  the  other  hand,  where  there  is  a  mere  cloudy  dimness 
and  small  spots  of  cataract,  we  must  use  candle-light  or  some  illumi- 
nating power  such  as  an  ophthalmoscope  and  a  strong  light  to  see  the 
27 


418 


DISEASES  OF  THE  EYES 


action  of  the  lens  in  the  eye  itself.  Before  doing  so,  however,  we  must 
dilate  the  pupil  with  atropia. 

Discoloration  of  the  lens  may  be  caused  by  violent  concussion,  con- 
tusion of  the  eyeball,  and  by  various  pathological  conditions  in  the 
interior  of  the  eye.  It  may  be  congenital,  the  lens  being  in  a  variety  of 
positions  in  the  eye,  sometimes  it  is  necessary  to  dilate  the  pupil  by 
means  of  atropine  to  ascertain  the  exact  position  of  the  lens. 

The  prognosis  is  rather  difficult  to  make,  and,  as  a  rule,  it  should 
be  an  unfavorable  one.  Hereditary  cataract  shows  little  inclination  to 
enlargement,  as  is  also  the  case  in  senile  cataract.  In  soft  cortical  cata- 
racts seen  in  young  animals,  we  may  see  a  rapid  opacity  of  the  lens  in  a 
few  days  or  weeks.  The  sight  is  entirely  lost  and  medical  treatment 
is  of  little  use. 

Therapeutic  Treatment. — In  the  early  stages  of  senile  cataract  very 
good  results  have  been  obtained  with  iodide  of  potassium,  1  per  cent. 


Fig.  143. — a.  Stop  discission  needle;  b,  Graefe's  cataract  loiife;  c,  DavieFs  cataract  spoon. 

solution,  few  drops  in  the  eye  daily.  A  gray  cataract  may  be  removed 
by  an  operation,  and  this  is  much  more  advisable  in  the  dog  because 
it  is,  as  a  rule,  particularly  in  young  dogs,  attended  with  no  great 
danger,  and  its  results  are  generally  beneficial,  producing  a  partial  res- 
toration of  the  vision.  It  is  advisable  to  perform  the  operation  of 
cataract  after  having  first  dilated  the  pupil  by  means  of  atropia,  and 
then  performing  the  operation  under  ether.  The  writer  has  tried 
cocaine  alone,  but  he  finds  it  unsatisfactory.  The  animal  must  be 
tied  up,  placed  on  a  table,  and  ether  or  chloroform  administered.  The 
operation  is  performed  by  one  of  the  following  methods: 

Opening  of  the  Capsule. — The  anterior  capsule  of  the  lens  has  to  be 
opened  in  a  transverse  way  with  what  is  known  as  a  discission  needle 


DISEASES  OF  THE  CRYSTALLIXE  LENS  419 

(Fig.  143,  a).  The  fluid  in  the  anterior  chamber  causes  a  gradual  break- 
ing up  and  reabsorption  of  the  lens.  An  assistant  holds  the  eyelids  open 
and  the  operator  seizes  a  fold  of  the  conjunctiva  with  a  small  tenaculum, 
holding  the  eye  firmly  with  the  left  hand,  while  holding  the  needle  in 
the  right  hand,  placed  on  the  animal's  head  to  steady  it.  The  needle 
is  then  introduced  into  the  cornea,  in  the  middle  of  the  lower  external 
quadrant,  in  such  a  direction  as  to  meet  the  ciliary  insertion  of  the  iris 
and  as  far  as  the  upper  internal  quadrant.  Before  the  point  of  the 
needle  has  reached  this  latter  point,  however,  it  is  placed  firmly  on  the 
capsule  of  the  lens,  and  this  is  cut  through  in  a  transverse  direction  with  a 
lever-like  movement  of  the  needle  (Fig.  144) .  The  instrument  must  then 
be  removed  in  the  same  way  that  it  was  introduced  in  perforating  the 
cornea.     After  the  operation  the  animal  must  be  placed  for  some  time 

b 
a. 


Fig.  144. — Discission  of  the  lens:  a,  Form  and  size  of  the  cross-incisions;  6,  method  of  insertion 

of  the  needle. 

in  a  dark  place  and  the  eye  treated  twice  a  day  with  atropine.  We  must 
treat  all  irritating  symptoms  of  the  eye  by  means  of  cold  compresses, 
and  sometimes  we  must  use  mild  laxatives.  After  six  or  eight  weeks 
the  reabsorption  of  the  lens  is  complete.  We  generally  perform  dis- 
cission in  young  animals  affected  with  soft  cataract.  The  result  of  this 
operation,  however,  is  not  always  satisfactory,  as  reabsorption  is  slow 
and  in  many  cases  requires  a  second  operation.  Several  months  may 
also  elapse  before  the  cataract  is  absorbed.  Schlampp  advises  in  such 
cases  puncturing  the  cornea,  and  by  this  means  slowly  allowing  the 
fluid  of  the  anterior  chamber  to  escape,  leaving  the  lens  untouched. 
Anterior  displacement  of  the  lens  enlarges  or  ruptures  the  opening 
which  has  been  made  in  the  capsule.  Reabsorption  follows,  as  a  rule, 
more  quickly  when  this  is  performed,  probably  due  to  the  fact  that  the 
fluid  which  contains  the  elements  of  the  lens  has  been  discharged  and 
replaced  by  fresh  fluid.  The  process  is  not  dangerous,  and  may  be 
repeated  much  oftener  than  discission. 

Linear  Extraction. — This  operation  is  used  where  there  is  complete 
opacity  of  the  lens  and  enlargement  of  the  lens  and  contraction  of  the 


420 


DISEASES  OF  THE  EYES 


anterior  chamber.  After  liaving  prepared  the  dog  as  in  the  operation 
for  discission,  an  assistant  holding  the  eyelids  apart,  with  another 
forceps  seize  the  conjunctiva  of  the  eyeball  in  the  neighborhood 
of  the  median  line  of  the  eyeball,  at  the  same  time  everting  the  upper 
eyelid.  We  then  make  an  incision  by  means  of  Graefe's  cataract  knife 
(Fig.  143,  b),  about  5  mm.  broad,  through  the  cornea,  about  2  or  3  mm. 
from  the  border  of  the  sclerotic  membrane.  We  then  pass  a  discission 
needle  through  the  wound,  split  open  the  lenticular  capsule,  as  in  discis- 
sion, and  empty  the  soft  parts  of  the  cataract  by  means  of  Daviel's 
spoon  (Fig.  143,  c).  Any  remnants  of  the  cut  capsule  which  may  not 
be  removed  at  the  time  are  left  to  be  reabsorbed.  If  during  the  operation 
Ave  observe  prolapsus  of  the  iris,  we  must  try  to  restore  it  to  its  position 


'  ■%//#fMii;m'# 


Fig.   145. — Lobular  extraction  of  leii.s.      {Cadiot  and  Breton.) 

by  means  of  Daviel's  spoon  (Fig.  143,  c).  If  this  is  not  possible,  we 
may  cut  it  off  close  to  the  wound  of  the  cornea. 

It  is  very  evident  that  linear  extraction  is  only  to  be  performed  in 
cases  of  complete  softening  of  the  lens.  This  may  be  recognized  liy 
total  opacity  of  the  lens  and  alteration  of  the  iris,  and  also  when  the 
anterior  ca])sule  is  pushed  toward  the  cornea. 

Lobular  Extraction. — Lobular  extraction  is  indicated  in  hard  cata- 
ract, which  is  generally  senile,  where  the  lens  may  be  prolapsed  into  the 
anterior  chamber  and  where  discission  will  only  produce  an  imperfect 
result — that  is  to  say,  where  reabsorption  of  the  lens  does  not  progress 
properly.     It  is  performed  in  the  following  manner: 

Make  an  incision  into  the  cornea  exactly  as  in  linear  extraction,  by 
means  of  Graefe's  cataract  knife,  but  it  must  be  enlarged  to  8  or  10  mm, 
(Fig.  145).  After  that  the  capsule  of  the  lens  is  split  by  the  discission 
needle,  the  fluid  of  the  anterior  chamber  is  allowed  to  escape,  and  at  the 


DISEASES  OF  THE  CRYSTALLINE  LENS 


421 


same  time  the  lens  must  be  detached  by  means  of  an  even,  but  not  too 
energetic,  pressure  upon  the  other  side  of  the  eye  from  the  wound,  and 
then  by  means  of  the  Daviel  's  spoon  the  lens  is  pushed  out  of  the  opening 


Fig.  146. — Lobular  extraction  of  lens.     (Cadiot  and  Breton.) 

(Fig.  140) .     The  subsequent  treatment  is  the  same  as  in  linear  extraction. 

Dislocation   of  the  Lens. — This   operation   is  undertaken  in  hard 
cataract,  and  is  performed  in  the  following  manner: 

By  means  of  a  cataract  needle  pushed  through  the  sclerotic  mem- 


FiG.  147. — Dislocation  of  the  lens.      (Cadiot  and  Breton.) 

brane,  or  the  cornea,  steady  pressure  was  made  on  the  upper  part  of  the 
lens,  and  it  was  pushed  down  into  the  lower  posterior  part  of  the  vitreous 
chamber  of  the  eye.  The  needle  is  held  like  a  penholder  and  is  introduced 
into  the  sclerotic  membrane  at  the  side  of  the  eye  about  2  to  4  mm. 


422  DISEASES  OF  THE  EYES 

distant  from  the  corneal  border  and  is  pushed  underneath  the  iris, 
between  it  and  the  lens  to  the  median  line,  until  it  is  visible  in  the  pupil. 
When  the  needle  has  reached  the  inner  or  nasal  border  of  the  pupil,  the 
needle  is  pushed  back  against  the  lens  and  by  steady  pressure  the  lens 
is  dislocated  from  its  supports  and  pushed  backwards  into  the  vitreous 
humor.  The  lens  must  be  held  in  position  to  endeavor  to  prevent  its 
return,  but  it  is  very  apt  at  times  to  partially  re-enter  the  pupillary 
opening. 

DISEASES  OF  THE   SCLEROTIC  MEMBRANE,  OF  THE 

NERVOUS  PORTION  OF  THE  EYE,  AND  ALSO 

OF  THE  VITREOUS  HUMOR. 

These  diseases  are  generally  not  of  any  great  importance  compared 
with  the  diseases  before  described,  and  therefore  we  will  not  go  into 
minute  details. 

Anomalies  of  the  Iris. — Of  this  organ  there  are  two  kinds:  Persistent 
papillary  nieml)rane  and  iris  coloboma. 

Persistent  Papillary  Membrane  {Memhrana  Papillaris  Perservatrs) . — 
The  foetal  papillary  membrane  extends  in  the  shape  of  threads  or  strings 
from  the  anterior  surface  of  the  iris  to  the  capsule  or  over  the  pupil,  or 
their  free  ends  may  also  float  in  the  aqueous  humor.  Calve  saw  a  young 
dog,  twelve  months  old,  afTected  like  this  and  saw  a  similar  condition  in 
the  mother,  and  several  of  her  offspring  were  blind  from  persistent 
papillary  membrane  Moeller  has  seen  a  number  of  young  dogs  affected 
in  the  same  manner. 

Iris  Coloboma. — This  is  a  congenital  split  or  division  of  the  iris, 
which  is  not  at  all  rare.  In  the  iris  are  found  circular  split-like  openings 
and  there  appear  to  be  two  and  sometimes  three  pupils  (Fig.  148). 
There  are  also  associated  with  this  condition  alterations  in  the  ciliary 
body  of  the  choroid  membrane. 

Inflammation  of  the  Choroid. — This  condition  is  very  similar  to 
iritis,  and  the  synii)toms  are  similar.  Treatment  consists  in  keeping 
the  animal  in  a  dark  place  and  solutions  of  cocaine  to  the  eye. 

Inflammation  of  the  Iris  {Ii'itis). — This  affection  is  very  rare  in  the 
dog  and  is  apt  to  be  associated  with  keratitis,  cyclitis,  or  choroiditis.  It 
may  also  be  due  to  extension  of  inflammatory  processes  and  to  trauma- 
tisms, and  is  also  said  to  be  associated  with  rheumatoid  conditions  and 
distemper.  It  may  be  recognized  by  contraction  and  difficulty  of  move- 
ment of  the  iris,  change  in  the  color  of  the  iris,  fibrous  accumulations  in 
the  shape  of  a  gray  veil-like  coating,  and  dulness  of  the  fluid  of  the 
anterior  chamber,  and  slight  dimness  of  the  cornea.  The  cure  for  this 
disease  consists  in  complete  rest,  keeping  the  animal  in  a  dark  place, 


INFLAMMATION  OF  THE  SCLEROTIC  COAT 


423 


and  solutions  of  cocaine  and  atropine,  and  the  administration  of  saline 
laxatives. 

Purulent  Inflammation  of  the  Eye  (Panophthahjiitis). — This  is 
produced  by  serious  concussion  of  the  eye  itself.  It  may  also  be  due  to 
septic  wounds  of  the  cornea  and  sclerotic  membrane,  as  well  as  to  the 
large  perforating  ulcers  of  the  cornea.  "We  recognize  the  following 
acute  symptoms: 

The  eyelids  are  constantly  closed;  great  redness  of  the  conjunctiva; 
total  opacity  of  the  cornea;  purulent  accumulations  in^the  anterior 
chamber  of  the  eye  (hypopyon) ;  great  hardness  and  enlargement  of  the 
bulbus.  After  a  short  time  we  may  have  perforation  through  the  cornea, 
and,  in  rare  cases,  through  the  sclerotic  membrane.     The  lens  and  vitre- 


^  \        ^\'<  J'  / 


Fig.   148. — Iris  coloboma. 

ous  humor  are  ejected  through  the  opening  with  the  purulent  mass;  the 
eyeball  collapses,  becomes  contracted,  and  forms  a  knob-shaped  mass  in 
the  eye;  the  lids  completely  collapse  and  form  a  hollow  in  the  face.  The 
only  thing  to  do  in  such  a  case  is  to  perform  enucleation,  or  removal  of 
the  eye.     See  Removal  of  EyelDall. 

Glaucoma  and  Hydrophthalmus.  Dropsy  of  the  Anterior  Chamber. — 
It  is  impossible  to  draw  a  distinct  line  between  these  two  conditions. 
The  anterior  chamber  is  very  much  enlarged,  hard  and  tense,  so  much 
so  that  the  eyelids  cannot  be  closed  (goggle  eye,  exophthalmus).  The 
blood  vessels  of  the  conjunctiva  and  the  sclerotic  membrane  are  injected, 
the  cornea  more  or  less  opaque,  the  pupil  much  contracted  and  greenish 
in  color,  insensibility  of  the  cornea,  and  dilatation  of  the  pupil.  The 
animal  has  partial  or  total  loss  of  eyesight,  congestion  of  the  conjunctiva, 


424  DISEASES  OF  THE  EYES 

and  greenish  coloration  of  the  i)upiL  Treatment  consists  of  a  few  drops 
of  physostigmin  sohition  1  to  100,  which  tends  to  reduce  the  intraocuhir 
pressure,  and  puncture  of  the  cornea.  In  chronic  hydrophthahiius  the 
entire  eyeball  had  best  be  removed.  Iridectomy  is  performed  in  man 
for  glaucoma  and  Gra>fe  has  recommended  it  for  the  dog. 

Diseases  of  the  Vitreous  Humor. — These  are  generally  congenital 
and  are  observed  with  the  ophthalmoscope.  The  vitreous  humor  is  found 
on  examination  to  be  filled  by  a  filiform  or  striated  opacity;  in  some  cases 
the  vitreous  humor  is  found  to  be  a  mobile  liquid.  There  are  a  number  of 
other  changes,  but  this  condition  is  incurable,  and  merely  for  diagnostic 
purposes,  consequently,  works  on  the  eye  are  to  be  consulted.  Of  these 
diseases  there  are  a  number  of  anomalies,  but  the  most  important  are 
hemorrhage  of  the  retina,  inflammation  of  the  papilla  of  the  optic  nerve, 
and  detachment  of  the  retina,  total  cataract  and  a  partial  luxation  of  the 
lens,  licpefaction  of  the  vitreous  humor  of  the  eye,  swelling  of  the  papilla, 
and  injection  of  the  vessels  of  the  retina. 

Hemorrhage  of  the  Retina. — This  may  be  caused  by  violent  trau- 
matism and  from  certain  diseases  such  as  scurvy,  ptomaine  poison  and 
from  poisoning  from  male  fern  extract  given  for  tape-worm.  Those 
which  are  only  visible  with  the  ophthalmoscope  are  round,  irregular  line- 
like bodies,  brownish-yellow,  which  gradually  become  light  yellow  or 
white.  Treatment  is  generally  useless.  Rest,  moist,  warm  compresses, 
the  application  of  a  1-per  cent,  solution  of  iodide  of  potassium,  a  few 
drops  in  the  eye  once  or  twice  daily. 

Inflammation  of  the  Papilla  of  the  Optic  Nerve  (Papillitis,  Neuritis 
Intraocular  is). — This  is  apt  to  be  found  associated  with  pathological  con- 
ditions in  the  other  structures  of  the  eye  from  certain  infectious  diseases — ■ 
distemper,  septicaemia,  ptomaine  poisoning,  and  rarely  traumatisms. 
The  papilla  when  examined  by  the  ophthalmoscope  is  found  to  be  hyper- 
aemic,  with  more  or  less  projection  of  the  papilla,  and  congestion  of 
the  surrounding  vessels.  When  the  active  symptoms  subside  the 
papilla  atrophies,  becomes  grayish-white  and  becomes  oval  or  circular. 

The  treatment  consists  in  keeping  the  animal  in  a  dark  room, 
administering  strychnine  and  local  applications  of  sedatives,  and  small 
doses  of  calomel. 

Detachment  of  the  Retina  {Amotio  Retincr). — This  is  indicated  by 
more  or  less  separation  of  the  choroid  and  opacit}^  of  the  vitreous  humor 
when  there  is  complete  separation  of  the  retina;  the  whole  body  becomes 
converted  into  a  funnel-like  body.  This  condition  has  been  observed 
quite  frequently.  Moeller  has  found  numerous  cases  of  detachment  of 
the  retina,  and  could  find  no  predisposing  cause.  8ubretinal  cysts  are 
occasionally  found  in  the  retina?  of  old  dogs,  and  present  the  same  symp- 
toms as  this  disease.     Treatment  is  useless. 


PROLAPSE  OF  THE  EYEBALL  425 

Amaurosis.  Black  Cataract. — Under  this  title  we  class  all  of  those 
morbid  states  where  there  is  partial  (amblyopia)  or  complete  loss  of 
eyesight  or  blindness  (amaurosis)  without  any  change  in  the  external 
portion  of  the  eye.  In  the  majority  of  cases  it  is  due  to  pathological 
process  in  the  retina  or  the  optic  nerve,  namely  retinal  hemorrhage, 
separation  of  the  retina,  papillitis,  retinitis,  or  atrophy  of  the  optic  nerve. 
In  rare  instances  it  is  due  to  direct  pressure  of  hemorrhages  on  the  optic 
nerve,  or  to  inflammations  to  neof ormations  in  the  orbit,  or  at  the  entrance 
of  the  optic  nerve,  or  it  may  be  due  to  certain  lesions  in  the  cranial 
cavity,  such  as  inflammation,  hemorrhage,  tumors,  parasites,  which  are 
located  in  the  base  of  the  brain  near  the  optic  centre.  Certain  poisons 
have  a  specific  effect  on  the  optic  nerves  and  cause  permanent  or  tem- 
porary blindness  such  as  nicotine,  salicylic  acid,  extract  of  male  fern, 
santonin,  carbon  dioxide,  or  decayed  meat  toxines.  The  sight  is  some- 
times affected  by  sporting  dogs  working  in  the  field  when  it  is  covered 
with  snow.  Congenital  amaurosis  cannot  be  said  to  be  extremely  rare, 
it  being  rather  common  in  toy  terriers  and  particularly  so  in  Boston 
terriers. 

Symptoms. — "When  a  dog  is  blind  in  both  eyes  it  is  not  difficult  to 
determine  the  condition,  on  observing  the  careful  method  of  walking, 
the  absence  of  fright  when  menaced  with  a  stick  or  hand,  and  the  very 
much  increased  use  of  the  sense  of  smell,  or  of  hitting  obstacles  or 
walking  into  them,  and,  in  addition,  the  fixed,  stary  look,  and  the  dilata- 
tion of  the  pupils  which  do  not  contract  in  the  presence  of  strong  light. 
Cases  have  been  observed  where  there  was  pronounced  amaurosis  and 
W'hile  the  pupil  was  ordinarily  dilated,  when  the  animal  was  brought 
into  strong  light  the  pupil  contracted.  Where  there  is  partial  or  com- 
plete loss  of  sight  in  only  one  eye,  it  is  more  difficult  to  determine  the 
condition.  Blind  one  eye  w'ith  some  dark  material  and  try  to  see 
whether  the  pupil  dilates  and  contracts  with  the  light.  A  peculiar  form 
of  blindness  is  hemeralopia  (night  blindness) ,  In  such  animals  the  sight 
is  perfectly  good  in  the  day,  but  at  night  the  sight  is  partially  lost  and 
the  animal  has  no  confidence  in  walking  about.  This  condition  is  found 
to  be  due  to  a  peripheral  opacity  of  the  refractory  mediums.  The  treat- 
ment consists  in  the  attempt  to  remove  the  exciting  cause,  if  possible. 

Prolapse  of  the  Eyeball. 

(Exophthalmus;   Prolapsus  Bulhi  Oculi.) 

There  are  a  number  of  causes  that  produce  prolapse  of  the  eyeball. 
It  may  be  crowded  out  of  the  cavity  of  the  eye,  or  exposed  in  its  external 
circumference  by  the  swollen  and  distended  eyelids  which  are  closely 
adherent    to   its   posterior   surface    (Fig.  149).     This    condition   occurs 


426  DISEASES  OF  THE  EYES 

especially  in  bulldogs,  pugs  and  the  toy  spaniels,  although  it  may  occur 
in  any  breed.  The  dog  does  not  possess  a  complete  bony  arch  of  the 
eye  (zygomaticus),  the  space  being  filled  up  by  a  ligament,  and  the 
muscles  are  also  very  weak.  Occasionally,  from  some  mechanical  force, 
such  as  blows  in  the  region  of  the  eye,  or  bites  in  its  neighborhood 
causing  hemorrhage  and  a  large  amount  of  blood  to  collect  in  the  posterior 
part  of  the  orbit,  it  is  pushed  out  of  position.  Frec|uently  the  entire 
eyeball  is  crowded  out,  standing  out  on  the  face  clear  of  the  orbit,  (tumors, 
etc.)-  Simple  pressure  of  the  fingers  on  the  supraorbital  cavity  of  pugs 
or  spaniels  is  sufficient  to  make  the  eye  protrude,  opening  the  eyelids 
mechanically;  luxation  of  the  inferior  maxillary  also  causes  protrusion 
of  the  eyeball.     It  is  also  observed  in  that  rare  affection  called  Basedow's 


-tr-^i^ 


n 

1     , 

H 

1" 

'  $'i.^ 

•  ''    '^-  ; 

Mr 

It: 

Fig.   149. — Dislocation  of  the  eyeball. 

disease.  This  condition  has  been  noticed  in  very  rare  instances  to  be 
due  to  inflammatory  processes  inside  the  eye,  and  by  the  formation  of 
tumors  in  the  orbits. 

The  prognosis  of  a  prolapsed  eyeball  depends  largely  upon  the  cir- 
cumstances and  condition  of  the  organ.  If  the  prolapse  is  of  recent 
origin,  if  the  muscles  of  the  eye  and  optic  nerve  are  not  torn,  and  if  the 
eye  itself  has  not  been  very  much  injured,  we  may  expect  complete 
recovery  in  a  short  time  without  any  disturbance  of  sight.  If  the  pro- 
lapse is  recent  and  the  muscles  are  not  torn,  or  only  partially  so,  but  the 
eye  is  al)normally  distended,  we  must  expect  there  is  some  irritation  of 
the  optic  nerve,  and  while  the  eye  may  be  restored  the  animal  may 
remain  blind.  If  the  muscles  of  the  eye  and  optic  nerve  are  lacerated 
and  the  eye  proper  is  injured,  or  if  any  of  the  chambers  of  the  eye  are 
filled  with  blood,  or  if  the  prolapse  has  been  sufficiently  long  that  the 
irritating  influence  of  the  air  is  marked  by  an  opacity  and  a  dry  look  of 


PROLAPSE  OF  THE  EYEBALL  427 

the  cornea,  which  assumes  a  horny  appearance,  the  eye  must  be  con- 
sidered as  lost. 

The  therapeutic  treatment  consists  in  returning  the  eyeball  as  soon 
as  possil)le,  especially  when  the  organ  appears  to  be  in  such  a  condition 
as  would  encourage  you  to  think  it  can  be  saved;  but  if  otherv.-ise,  it 
must  be  removed  as  soon  as  i3ossible. 

We  try  to  return  the  eye  to  its  position  as  soon  as  possible. 

First,  clean  it  thoroughly  by  means  of  an  antiseptic  that  is  not 
irritating,  such  as  a  2  per  cent,  solution  of  boric  acid  or  a  1  to  2000 
solution  of  corrosive  sublimate.  Place  the  fiat  of  the  hand  or  the  points 
of  the  fingers  on  the  eyeball,  at  the  same  time  an  assistant  distending  the 
eyelids  as  much  as  possible,  and  by  gentle  pressure  endeavor  to  push  the 
eye  l^ack  into  the  orbital  cavity. 

If  it  is  impossil)le  to  return  it  by  this  means,  the  fissure  of  the  eye 
must  be  enlarged  by  making  a  small  incision  in  the  external  corner,  or 
the  anterior  chamber  of  the  eye  may  be  perforated  by  means  of  a  cataract 
needle  or  sharp  l^istoury,  so  as  to  empty  the  eye  to  a  certain  extent  and 
thus  allow  it  to  return  to  the  chamber.  After  returning  the  eye  we  must 
try  to  prevent  another  prolapse  by  placing  a  bandage  over  the  eye, 
taking  care  not  to  compress  the  eyeball  too  much.  If  the  animal  will 
not  allow  it  to  remain,  we  must  join  the  eyelids  with  one  or  two  stitches. 
After  stitching  the  eye  we  generally  see  great  inflammation  of  the  lids 
and  the  eye  itself,  but  the  writer  has  found  that  these  bad  effects  may  be 
easily  prevented  by  taking  care  not  to  carry  the  stitch  through  the  entire 
lid,  but  only  through  the  external  membrane.  At  the  same  time  it  is 
advisable  to  keep  the  animal  without  food  for  at  least  twenty-four  hours, 
for  the  use  of  the  jaw,  and  especially  the  pressure  of  the  prolongation  of 
the  crown  of  the  inferior  maxillary,  may  push  the  injured  eye  out  of 
position.  Cold  applications  are  useful  if  the  eyeball  cannot  be  saved,  or 
if  reduction  is  impracticable  for  some  reason  or  other,  on  account  of 
tumors  in  the  orbit,  etc.,  there  is  nothing  left  to  do  but  enucleate  the 
eyeball. 

Enucleation.  Removal  of  the  Eyeball. — Removal  of  the  eyeball 
should  be  performed  under  a  narcotic  or  ether,  or  continual  applications 
of  4  per  cent,  solution  of  cocaine.  We  pull  out  the  eyeball  by  means  of 
a  tenaculum  or  a  thread  is  put  in  the  body  of  the  eye,  cut  through  the 
conjunctiva  with  a  pair  of  small  curved  scissors  closely  behind  the  cornea, 
snipping  the  scissors  around  the  eye,  keeping  as  close  to  the  bulb  of  the 
eye  as  possible,  and  by  this  means  separate  the  muscles  and  then  cut 
through  the  optic  nerve.  The  author  thinks  it  is  advisable  to  remove 
the  membrana  nictitans  at  the  same  time  (Fig.  150). 

After  enucleation,  the  cavity  of  the  eye  is  washed  out  with  an  anti- 
septic fluid  and  the  bleeding  is  stopped  by  means  of  a  tampon;  and  the 


428 


DISEASES  OF  THE  EYES 


cavity  should  he  powdered  with  boracic  acid  or  sulphonal.  Pack  the  orbit 
with  absorbent  cotton  and  put  two  stitches  in  the  eyelids.  The  stitches 
and  packing  must  be  removed  in  twenty-four  hours.  The  further  treat- 
ment consists  in  cleaning  out  the  cavity  with  corrosive  sublimate  solution 
(1  to  3000)  twice  daily.  Dogs  are  not  badly  disfigured  by  the  loss  of 
one  eye,  as  the  orbit  becomes  contracted  and  partially  filled  with  granula- 


FiG.   150. — Muscles  of  the  left  eye:  a,  Superior;  b,  external;  c,  inferior  straight  muscles  of  the  eye;    1 
eyeball;  2,  orbital  arch  cut  through. 

tions.  It  is  not  advisable  to  use  artificial  eyes,  as  the  animal  generally 
rubs  them  out,  and  such  operations  as  tattooing  the  stump,  only  removing 
the  anterior  portion  of  the  eye,  or  cleaning  out  the  contents  of  the  eye- 
ball and  stitching  up  the  sclerotic  membrane  are  not  only  invariably 
impracticable  but  very  apt  to  act  an  as  irritant  and  cause  a  constant 
discharge  from  the  cavity,  and  the  empty  orbit  always  presents  a  dis- 
gusting appearance. 


DISEASES  OF  THE  EAR, 

Serous  Cyst. 
{Othematoma;  Hanatonia.) 

By  this  term  we  mean  a  blood  or  lymphatic  excretion  lying  between 
the  skin  and  cartilage  of  the  ear,  and  forming  a  tumor  in  the  external 
or  internal  part  of  the  lobe.  It  generally  occurs  on  the  inside  of  the  lobe. 
In  rare  cases  it  has  been  found  in  the  external  side,  and  in  still  rarer  cases 
both  inside  and  outside.  This  swelling  is  fluctuating,  and  when  the  skin 
of  the  animal  is  white  it  may  have  a  bluish  coloration. 

Etiology. — This  condition  is  probably  due  to  some  irritation  or 
traumatic  cause;  for  instance,  by  striking  the  ear  against  the  collar  or  muz- 
zle, pulling  the  ear,  concussions,  and  injuries  through  biting;  or  from  con- 
stant shaking  the  ear  due  to  the  continuous  itching  and  irritation  of  disease 
of  the  middle  ear  and  from  irritation  of  parasites,  or  ulceration  of  the  edges 
of  the  lobes.  It  is  alwaj-^s  seen  in  the  lobe  of  the  ear;  it  is  general  in  dogs 
with  long  ears.  If  the  sac  is  not  emptied  by  surgical  means,  the  secretion 
remains  fluid  and  to  a  certain  extent  is  reabsorbed,  but  rarely  is  the 
secretion  entirely  reabsorbed  and  it  may  leave  quite  a  thickening  and 
even  malformation  of  the  external  ear,  and  when  the  sac  is  emptied  by 
surgical  means  after  the  collection  has  been  there  some  time  we  find  that 
there  is  very  little  serous  fluid  left,  but  organized  masses  of  filiform 
neoformations.  In  some  cases  when  the  fluid  suppurates  it  may  perfor- 
ate the  skin  externally.  This,  however,  is  very  rare,  being  generally 
associated  with  some  later  traumatisms. 

Clinical  Symptoms  and  Prognosis. — The  swelling,  as  a  rule,  is  on  the 
internal  part  of  the  ear.  This  enlargement  varies  in  size  from  a  pigeon 
to  a  chicken  egg,  spherical  or  oval  in  shape.  The  lobe,  which  generally 
hangs  downward,  is  pushed  upward  in  a  peculiar  manner  (Fig.  151). 
The  swelling  is  hard,  and  in  white  animals  it  has  a  blue  color.  It  is  very 
sensitive  to  pressure  and  shows  a  distinct  fluctuation.  The  animal 
carries  its  head  in  an  oblique  manner,  the  affected  ear  being  held  down- 
ward, and  when  the  collection  is  of  some  size  the  ear  stands  out  from  the 
head,  and  the  fact  that  it  gives  the  dog  more  or  less  pain  is  indicated  by 
the  careful  way  that  the  animal  shakes  its  head  or  scratches  its  ear. 

The  prognosis  is  favorable  provided  proper  treatment  (incision,  etc.) 
is  applied,  although  it  may  take  some  time  before  they  are  entirely  cured. 
Compression  of  the  ear  by  means  of  bandages  has  been  found  to  induce 
the  course  of  healing  very  materially. 

429 


430 


DISEASES  OF  THE  EAR 


In  many  cases  where  no  dressing  is  applied,  we  may  have  as  a 
sequence  a  slight  thickening  of  the  lobe  of  the  ear.  This,  however,  is 
of  very  little  importance. 


Fig.  151. — Hematoma  oi  the  ear. 


Therapeutic  Treatment. — The  methods  of  treatment  which  the 
waiter  considers  advisable  are  as  follows: 

We  perforate  the  swelling  with  a  large-sized  hypodermic  syringe 
or  aspirator.     The  secretion  is  then  removed  and  a  solution  of  iodine  1, 


Fig.  152. — Ear-cap. 


iodide  of  potassium  G  and  alcohol  IG  is  injected  into  the  cavity.     We 
then  apply  a  compressing  dressing  in  the  following  manner: 

The  ear  is  covered  with  antiseptic  wadding  on  both  surfaces.     It  is 


SEROUS  CYST  431 

then  held  in  position  bj-  means  of  an  ear-cap  (Figs.  152,  153).  This  dress- 
ing must  not  be  clisphiced,  but  allowed  to  remain  for  days.  This  method 
has  been  an  element  of  uncertainty;  in  some  cases  it  acts  perfectly  and 
in  others,  beyond  setting  up  considerable  irritation,  it  does  not  destroy 
the  secreting  surface  and  the  abnormal  condition  returns. 

McQueen's  method  is  very  simple  and  produces  good  results.  He 
carefully  removes  the  hair  from  the  ear  and  renders  it  antiseptic,  and 
either  paints  the  ear  with  cocaine  or  administers  chloroform,  empties  the 
sac  by  means  of  an  aspirator  syringe,  and  makes  sure  that  it  is  com- 
pletely emptied.  Sutures  are  then  inserted  radiating  from  the  centre 
of  the  sac,  about  one-third  of  an  inch  apart,  directly  through  the  ear  and 


Fig.  153 — Ear  hood  or  net. 

tied  on  the  outer  or  hairy  side,  thus  producing  a  firm  pressure  between 
the  two  surfaces  of  the  sac  and  by  that  means  get  prompt  union.  The 
ear  must  then  be  irrigated  with  an  antiseptic  solution,  carefully  remov- 
ing all  blood,  etc.,  and  dressed  with  antiseptic  wadding,  and  further 
covered  with  an  ear-cap.  It  should  be  dressed  every  day,  and  the  sutures 
removed  at  the  end  of  a  week. 

Another  method  consists  in  taking  a  scalpel  and  making  a  free 
incision  from  one  end  of  the  sac  to  the  other,  then  filling  it  in  with 
tincture  of  iodine,  and  then  keeping  it  clean  and  using  an  ear-cap. 

Simple  emptying  by  means  of  a  trocar  or  making  a  small  incision 
never  produces  any  good  results,  as  the  opening  closes  immediately  and 
it  soon  fills  up  again.  Sutures  are  not  advisable,  causing  great  irritation. 
In  order  to  prevent  the  too  rapid  closing  of  the  incision,  the  removal  of 
a  small  crescent-shaped  piece  of  flesh  from  the  edge  of  the  opening  has 
been  recommended. 


432 


DISEASES  OF  THE  EAR 


Ulceration  of  the  External  Concha. — External  Canker. 

By  this  we  mean  a  purulent  or  ulcerative  process  on  the  edge  of  the 
external  ear.  This,  however,  is  not  contined  to  the  edge,  but  may  spread 
over  different  parts  of  the  lobe. 

Etiology. — The  chief  causes  of  this  trouble  are  injuries  and  lacerations 
of  the  skin.  Dogs  are  liable  to  scratch  or  shake  the  ears  violently  against 
the  muzzle  or  collar,  producing  an  inflammation.  It  may  also  be  devel- 
oped from  the  ear  itself,  as  in  cutaneous  inflammations  of  the  external 


Fig.  154. — Mode  of  bandaging  the  ear. 


auditory  passages.  We  may  also  see  this  as  a  re.sult  of  wounds  or  lacera- 
tions of  the  ear  caused  by  bites  of  other  dogs,  which  from  neglect  or 
improper  treatment  become  ulcerated  and  do  not  heal  readily  on  account 
of  constant  shaking  of  the  ear.  This  affection  is  almost  entirely  confined 
to  animals  with  long  ears  and  short  hair. 

Clinical  Symptoms. — The  animals  hold  their  heads  to  one  side, 
shaking  the  ear  frequently,  sometimes  keeping  it  up  so  long  that  the 
ulcerated  surface  bleeds  and  the  blood  is  thrown  in  all  directions.  They 
attempt  to  scratch  the  affected  ear  with  their  paws,  and  are  very  sensitive 
about  having  them  touched.     On  makinu-  an  examination  we  find  at  the 


EXTERNAL  CANKER  433 

edf^e  of  the  external  ear,  generally  at  its  extreme  end,  an  ulcer  or  a 
number  of  them  which  are  covered  with  a  blackish  loose  scab  with 
turned-up  edges,  and  the  tissues  of  the  immediate  neighborhood  are 
oedematous. 

Therapeutic  Treatment. — The  first  procedure  is  to  ascertain  if  there 
are  any  evidences  of  internal  otitis;  if  so,  heal  that  and  lessen  the  irritation 
and  itching.  Xext  prepare  an  ear-cap  (Fig.  152),  which  is  so  very 
essential  in  this  affection.  Dress  the  inflamed  edges  first  with  an  anti- 
septic solution  and  get  all  the  scab-dirt,  broken  down  tissue  and  hair 
away,  then  paint  the  edges  with  compound  tincture  of  benzoin  and 
apply  this  daily,  keeping  on  the  ear-cap.  Other  ointments,  such  as  airol, 
benzoin  and  lanolin,  or  stimulant  counter-irritants,  such  as  iodine  or 


nitrate  of  silver  may  be  employed.  The  writer  has  found  the  following 
method  very  efficacious :  Clean  the  ear  thoroughly,  then  apply  freely 
some  drj'ing  powder,  such  as  dermatol  or  boric  acid,  on  both  sides  and 
the  edges  of  the  ear.  Have  prepared  an  oblong  piece  of  linen  or  muslin 
as  in  the  accompanj-ing  illustrations  (Figs.  154, 155) ,  cover  this  with  liquid 
glue  and  apply  it  as  seen  in  the  Fig.  155;  this  is  held  in  position  until  dr>-. 
When  it  is  to  be  removed  the  ear  can  be  steeped  in  warm  water  and  it  is 
easily  removed.  It  is  best,  however,  to  let  it  remain  until  it  falls  off,  as 
by  that  time  the  ulcers  have  healed  and  the  scabs  and  hair  come  off  with 
the  bandages.  In  very  small  animals  silicate  of  soda  solution  or  rubber 
adhesive  plaster  can  be  substituted  for  glue,  but  in  ordinary-  sized  dogs 
the  glue  is  the  most  efficacious.  When  there  are  a  series  of  deep  tears 
or  chronic  separations  of  the  ears,  and  the  edges  of  the  ears  are  in  a 
chronic  state  of  inflammation,  with  more  or  less  induration  of  the  tissue, 
28 


434  DISEASES  OF  THE  EAR 

there  is  no  doubt  that  the  quickest  results  may  be  obtained  l^y  cutting 
off  a  portion  of  the  diseased  IoIdc  of  the  ear;  this,  however,  disfigures  the 
animal  very  much.  This  operation  is  generally  performed  on  animals 
under  the  influence  of  ether.  First  remove  the  hair  and  thoroughly 
disinfect  the  parts  and  cut  off  a  circular  piece  from  the  ear  that  will 
include  the  torn  portion,  being  careful  not  to  remove  any  more  of  the 
lobe  than  is  actually  necessary.  Another  method  is  to  cut  off  the  edges 
of  the  slit  ear  a  thin  section  about  one-eighth  of  an  inch  in  thickness, 
so  as  to  insure  two  raw  fresh  surfaces.  The  two  edges  of  the  wound 
must  then  be  drawn  together  by  means  of  sutures.  These  should  not 
be  inserted  too  close  to  the  edge  of  the  wound,  as  they  are  apt  to  tear 
through.  The  stitched  line  is  then  powdered  with  sulphonal.  The 
external  ear  is  covered  with  wadding,  turned  over  the  top  of  the  head, 
and  held  in  position  by  means  of  a  bandage,  as  indicated  in  Fig.  152 
and  153. 

The  writer  has  been  able  to  obtain  satisfactory  results  in  slight  cases 
of  external  otitis  and  canker  by  covering  the  ulcer  with  oxide  of  mercury 
and  tying  the  ear  in  a  cap. 

Inflammation  of  the  External  Auditory  Canal — Internal  Canker. 

{Otitis  Externa.) 

This  consists  of  an  inflammatory  irritation  of  the  external  canal  of 
the  ear.  It  occurs  most  frequently  in  dogs  with  long  ears.  It  is  gen- 
erally of  an  eczematous  nature  and  appears  in  a  diffuse  form,  extending 
over  a  larger  part  of  the  lining  of  the  ear.  It  is  accompanied  by  redness, 
swelling  of  the  membrane,  and  an  exudation  of  a  serous,  and,  later  in 
the  chronic  course,  a  purulent  secretion.  It  involves  the  papillary 
body  and  the  wax  secreting  glands  of  the  ear.  The  skin  is  tumefied,  red 
and  warm;  there  is  abundant  epithelial  desquamation;  the  ceruminous 
glands  secrete  a  very  much  increased  amount  of  al^normal  wax,  which 
collects  with  the  secretion  of  the  ear.  In  some  cases  the  discharge  becomes 
purulent  and  is  found  lying  in  the  ear  in  the  form  of  a  viscous  fluid,  vary- 
ing in  color  from  yellowish-brown,  gray-brown,  yellow-brown,  or  dark 
brown.  This  discharge  may  irritate  the  skin  of  the  lower  part  of  the  ear, 
causing  an  erythema.  We  may  also  have  the  formation  of  abscesses 
and  contraction  of  the  meatus  (caused  by  thickening  of  the  cutis,  by 
granulations,  and  by  polypus  malformations).  We  may  have  acute 
inflammation  of  the  canal  extending  deep  into  the  lining,  and  perforations 
of  the  tympanum  and  irritation  of  the  Eustachian  canal  and  discharge  of 
pus  into  the  pharynx.     Abscesses  of  the  parietal  bone  have  been  observed. 

Etiology. — The  causes  are  similar  to  those  mentioned  under  eczema. 
It  is  due  to  an  accumulation  of  cerumen,  dirt,  cutaneous  scabs,  and 


IXFLAMMATIOX  OF  THE  EXTERNAL  EAR 


435 


foreign  l:)odies;  also  too  frequent  bathing  with  soajD  is  a  common  canse  of 
irritation.  Sporting  dogs,  such  as  spaniels,  setters  and  retrievers  and 
Chesapeake  Bay  dogs,  from  going  into  icy  cold  water.  It  may  accompany 
or  follow  distemper,  or  by  extension  of  inflammatory  processes  from  the 
surrounding  tissues,  such  as  injuries,  bites,  etc.  It  is  also  recognized 
that  otitis  is  produced  by  acari.  (See  Parasitic  Otitis,  page  439).  Hoff- 
mann states  that  he  has  observed  serious  suppuration  in  cases  where 
dogs'  ears  have  been  clipped  too  close  to  the  head. 

Clinical  Symptoms  and  Prognosis. — Great  care  must  be  used  in 
making  the  first  examination  of  the  ear  to  distinguish  between  superficial 
and  deep  external  otitis.  In  the  former  form  it  may  rapidly  become 
chronic.  The  animals  shake  their  heads,  and,  as  the  disease  is  almost 
invariably  located  in  one  ear  only,  they  hold  their  head  in  an  oblic{ue 
position,  trying  to  scratch  the  head  about  the  base  of  the  ear  or  to  rub 
it  against  some  object.  They  carefully  avoid  any  attempt  which  is 
made  to  touch  the  ear,  and  show  great  pain  when  the  base 
of  the  concha  is  touched.  Milder  cases  rather  encourage 
manipulation  of  the  ear  and  if  the  ear  is  gently  rubbed  they 
show  every  sign  of  pleasure.  In  examining  the  external  ear 
we  use  a  forceps-shaped  speculum  or  ear-mirror  (Fig.  156). 
If  we  distend  the  canal  we  generally  find  it  filled  with  a 
foetid,  grayish-green,  or  reddish  liquid  consisting  of  gland- 
ular secretions,  fungi,  cutaneous  scabs,  pus,  acari,  etc. 
After  the  organ  is  cleaned  out  we  find  an  intensely  red, 
swollen,  sometimes  ulcerating  surface  of  the  skin.  In  the 
deep-seated  cases  the  meatus  is  almost  entirely  closed  by 
thickening  of  the  cutis  and  an  abundant  purulent  dis- 
charge from  the  ear  (otorrhcea).  Numerous  granulations 
appear  cjuickly  and  in  some  cases  where  both  ears  are 
affected  we  may  have  symptoms  of  impaired  hearing  or 
deafness.  A  characteristic  smacking  or  sucking  liciuicl 
sound  is  produced  by  side  pressure  or  rapid  compression  on  the  base  of 
the  ear. 

The  general  condition  of  the  animal  is  ver}'  seldom  affected.  Vomit- 
ing is  only  observed  in  exceptional  cases;  this  is  said  by  Froehner  to  be 
due  to  pressure  on  the  auditory  branch  of  the  vagus.  Vertigo,  spasms, 
and  epileptiform  convulsions  sometimes  follow  where  acari  are  present 
in  enormous  numbers. 

Therapeutic  Treatment. — The  treatment  which  corresponds  with 
that  of  eczema  is  generally  followed.  We  must  thoroughly  clean  the 
external  ear.  This  can  be  done  by  tying  a  piece  of  absorbent  cotton  or 
a  piece  of  sponge  on  the  end  of  one  of  the  ordinary  orange  sticks  used  in 
manicuring  (Fig.    157),  dipped  in  alcohol  or  ether;  warm  water,  made 


Fig.    156. 

Kramer's   ear 

speculum. 


436 


DISEASES  OF  THE  EAR 


slightly  alkaline,  can  also  be  used — the  two  former,  however,  are  to  be 
preferred.  "When  the  condition  is  chronic  a  syringe  must  be  used  to  get 
into  the  deep  parts  of  the  ear  and  the  best  for  this  purpose  is  one  made 
entirely  of  soft  rubber  with  a  long  flexible  point  that  can  be  pushed  into 
the  meatus  without  any  great  danger  of  injuring  the  canal;  the  flexible 
point  adapts  itself  to  the  turns  of  the  external  ear  canal,  and  by  using 
applications  of  warm  water  injected  into  the  meatus  the  latter  can  be 
thoroughly  cleansed  of  accumulated  cerumen,  crusts,  etc.  The  canal  is 
then  dried  with  absorbent  cotton  introduced  into  the  ear  on  the  end  of  a 
small  pair  of  forceps.  In  some  chronic  cases  great  benefit  is  to  be  had 
from  injecting  peroxide  of  hydrogen  into  the  ear,  as  it  cleans  it  out  thor- 


FiG.  157. — Ear  swab  and  mode  of  using  it. 


oughly,  but  under  no  circumstances  must  this  be  repeated  frequently  as 
the  peroxide  solution,  while  it  has  great  cleansing  properties,  if  repeated 
frequently,  attacks  the  normal  structure  of  the  ear  and  frequently  the 
writer  has  had  brought  to  him  cases  where  the  whole  inside  of  the  ear  and 
concha  was  a  mass  of  granulations,  in  what  was  originally  a  very  mild 
case,  caused  by  the  action  of  the  peroxide  solution. 

Syringings  with  water  and  fluids  of  any  kind  must  not  be  used  for 
any  length  of  time,  as  they  are  apt  to  carry  the  debris  of  the  condition, 
such  as  wax,  pus,  mucus,  scab,  etc.,  down  into  the  middle  ear.  On  the 
other  hand,  it  is  well  to  clean  out  the  ear  thoroughly  once  or  twice  with 
a  syringe  with  a  flexible  point.  As  the  meatus  is  elongated,  narrow,  and 
slightly  curved,  there  is  not  much  clanger  of  injuring  the  tympanic 
membrane.  In  very  slight  affections  of  this  character,  wdiich  may  be 
recognized  by  a  slight  redness  of  the  membrane,  itching,  and  the  presence 


INFLAMMATION  OF  THE  EXTERNAL  EAR  437 

of  a  certain  amount  of  fluid,  it  is  only  necessary  to  clean  the  meatus 
once  or  twice,  using  solutions  of  lead-water.  The  writer  has  found  that 
simply  powdering  with  lycopodium,  amylum,  talcum,  or  boracic  acid 
and  filling  up  the  ear,  and  then  massaging  the  base  of  the  concha  to  work 
the  powder  well  down  into  the  ear,  is  much  preferable  to  any  of  the 
above-mentioned  liquids. 

A  mode  of  procedure  suitable  to  most  cases  is  to  clean  the  ear  with 
wood  alcohol,  filling  in  the  cavity  and  working  the  alcohol  into  the  canal 
by  manipulation  of  the  base  of  the  ear.  It  is  then  to  be  dried  thoroughly 
with  absorbent  cotton  until  all  trace  of  brown  coloration,  characteristic 
of  this  condition,  is  removed.  Then  fill  up  the  ear  with  powdered  boric 
acid,  working  it  thoroughly  into  the  canal,  and  covering  all  the  inflamed 
portions.  This  should  be  repeated  every  third  day  until  the  irritation  is 
lessened,  and  then  after  that,  once  a  week.  With  this  treatment  also 
prescribe  a  laxative,  such  as  a  tablespoonful  of  saturated  solution  of 
sulphate  of  soda  (glauber  salts)  or  some  of  the  saline  laxative  waters. 
If  there  is  eczema  present,  add  to  the  treatment  two  drops  of  Fowler's 
solution,  morning  and  evening. 

In  serious  diseased  conditions  where  there  is  much  ulceration,  we 
may  treat  them  in  two  different  ways: 

By  syringing  the  ear  with  solutions  of  disinfecting  and  astringent 
agents,  such  as  salol  in  alcohol  (1  to  10),  tannin  in  glycerin  (1  to  10), 
This  must  be  repeated  several  times,  and  we  may  also  dry  up  the  secre- 
tion by  means  of  oxide  of  zinc  or  boric  acid;  the  latter  is  to  be  preferred. 
Hoffmann  advises  us  to  use  subnitrate  of  bismuth  or  sulphate  of  copper 
in  starch.  As  a  rule,  the  general  treatment  with  powders  is  preferable 
to  that  with  liquids,  but  the  latter  must  be  used  when  the  meatus  is 
much  contracted  and  the  ulcers  located  deeply — dermatol  in  starch 
powder,  1  to  10;  salicylic  acid  and  talcum  powder,  1  to  15;  tannoform, 
thioform,  dymal,  itrol,  etc.  An  ear-cap  is  only  necessary  when  the 
animal  is  constantly  shaking  its  head  and  the  organ  is  very  sensitive. 
Where  there  is  great  pain  a  few  drops  of  4  per  cent,  solution  of 
cocaine  is  useful.  We  remove  the  numerous  granular  accumulations 
by  means  of  nitrate  of  silver.  If  there  are  polypus  enlargements  they 
may  be  touched  with  a  thermocautery  or  cut  off  with  a  wire  ecraseur. 
When  the  auditory  canal  is  narrowed  by  extreme  tumefaction  of  the 
tissues,  frequent  syringing  with  warm  salicylic  acid  solution,  1  to  35, 
is  very  useful. 

T$.        Zinc  oxide,  3.0 

Talc,  12.0 

M.  F.  Pulv.  No.  I. 

Sig. — Ear  powder  twice  daily. 


438  DISEASES  OF  THE  EAR 

I^.        Bismuth  subgallate,  "3.0 

Amyl  nitrite, 

Talc,  aa  G.O 

Sig. — Twice  daily. 

I^.        Phenyl  salicylate,  2.0 

M.  F.  Spts.  vini  rect.,  80.0 

Sig. — Put  a  small  jjortion  in  the  ear  once  daily. 

Hoffmann  states  that  in  a  very  obstinate  case  he  excised  the  entire 
lower  region  of  the  meatus,  introduced  a  drainaoe-tulie,  and  treated  the 
Avound  ^vith  disinfecting  powder. 

Deafness,  Partial  or  Complete. 

External  otitis  may  sometimes  produce  either  partial  or  entire 
deafness.  Both  of  these  conditions  are  clue  to  the  entire  closure  of  the 
external  auditory  canal  either  by  swelling  and  filling  up  with  granulations 
or  by  polypus  formations,  collections  of  wax,  etc.,  and  more  rarely  liy 
extension  of  the  inflannnatory  process  in  the  middle  ear,  destroying  the 
tympanic  meml)rane,  or  up  the  Eustachian  tube  from  the  pharynx  or 
inflammation  of  the  lal)yrinth,  or  paralysis  of  the  auditory  nerve,  as 
well  as  certain  pathological  processes  in  the  cranium,  and  as  a  result  of 
certain  infectious  diseases,  particularly  distemper.  Of  course,  any  dis- 
turbance of  the  sense  of  hearing  or  entire  deafness  which  comes  from  old 
age  or  is  hereditary  will  not  show  any  of  the  symptoms  already  described. 
Breeding  a  pure  white-coated  dog  may  produce  a  congenital  deafness. 
This  is  particularly  seen  in  bull  terrier  puppies;  in  certain  strains  of 
this  breed  it  is  a  conmion  occurrence.  The  examination  generally  showed 
atrophy  of  the  auditory  nerve.  When  a  dog  is  getting  deaf  he  changes 
his  manner  very  much.  He  seems  strange,  does  not  answer  to  the  call 
of  his  master.  In  certain  cases,  when  an  animal  is  deaf,  the  loudest  call 
has  no  effect  on  him,  but  a  slight  blow  on  the  floor  immediately  attracts 
his  attention.  This  should  be  carefully  noticed,  as  certain  kennel  men, 
when  a  dog  is  protested  at  a  bench  show,  know  this  and  when  they  call 
on  their  dog  at  the  same  time  they  give  a  sharp  tap  on  the  floor  with 
their  heel,  which  immediately  attracts  the  dog's  attention. 

When  dogs  are  ])orn  deaf  they  either  do  not  attempt  to  bark  or,  if 
they  do,  it  is  a  peculiar  cry  more  like  a  howl. 

As  a  general  rule  there  is  very  little  result  from  treatment.  Where 
deafness  is  due  to  paralysis  of  the  auditory  nerve,  the  administration  of 
strychnine  or  the  faradic  current  should  be  tried.  Treatment  in  con- 
genital deafness  is  hopeless.  Where  thei'e  is  a  contraction  of  the  external 
meatus,  we  may  try  to  dilate  it  b}-  means  of  the  introduction  into  the 
canal  of  cylindrical  compressed  tampon  sponges. 


PARASITIC  CAXKER  OF  THE  EAR  439 

Parasitic  Canker  of  the  Ear. 

{Parasitic  Otitis.) 

Dermatophagus  Canis. 

The  symbiotes  auriculans  (canis)  is  a  parasite  that  inhabits  the  ear 
of  the  dog,  causing  an  aggravated  form  of  canicer  (Nocard  and  Sewell). 
The  parasite  which  is  common  to  the  dog  and  cat  is  said  to  produce  a 
peculiar  form  of  vertigo. 

The  parasite  differs  from  the  common  symbiot  by  the  absence  of 
abdominal  lobes  in  the  male,  which  are  represented  by  a  notch  which 
has  three  bristles.  The  pubescent  female  has  four  pairs  of  legs  which 
are  simple  knobs.  The  male  is  30  mm.  long  and  23  mm.  wide,  and  the 
female  is  42  mm.  long  and  29  mm.  wide  (Neumann)  (Fig.  158). 

Hering  found  moths  (dermatophagus  canis)  in  an  ulcer  of  the  ear 
Avhich  was  accompanied  by  a  deep-seated  otitis.  Nocard  describes 
minutely  certain  epileptiform  fits  in  which  the  dog  had  a  peculiar  husky 
cry  and  rushed  about  violently,  running  into  various  obstacles,  and 
finally  fell  insensible,  and  after  a  number  of  such  attacks  became  totally 
deaf.  Sewell  describes  the  condition  as  finding  a  collection  of  brown  or 
sooty-colored  cerumen  in  the  ear.  If  the  inside  of  the  ear  is  examined 
closely  a  number  of  tin)^  white  specks,  the  size  of  the  eye  of  a  needle,  are 
seen  to  be  rapidly  moving  about  the  ear,  and  he  believes  that  the  tickling 
sensation  caused  by  these  movements  and  the  biting  of  the  parasite  are 
what  produce  the  irritation  of  the  lining  membranes  of  the  ear.  Boden 
examined  every  case  brought  to  the  Dresden  canine  clinic,  but  failed  to 
find  a  case  due  to  parasites.  Frick  after  numerous  examinations  had 
the  same  result.  Cadiot  and  Newmann  describe  a  parasite  which  causes 
parasitic  otitis  (acariasis  auricularis,  otacariasis). 

Symptoms. — The  ear  is  hot  and  slightly  swollen,  and  on  examination 
it  is  hard  to  distinguish  it  from  ordinary  otitis.  There  is,  however,  less 
discharge  in  this  condition.  The  head  is  carried  to  one  side,  and  the 
animal  will  scratch  the  base  of  the  ear  very  gently  with  its  paw  and  whine 
in  a  plaintive  way.  After  having  observed  a  number  of  animals  infected 
with  the  parasite,  the  writer  is  inclined  to  think  that  the  carrying  of  the 
head  on  one  side  and  the  gentle  scratching  of  the  ear  are  characteristic 
of  the  disease,  although  it  is  quite  as  frequently  seen  in  non-parasitic 
otitis.  The  epileptiform  symptoms  described  by  Nocard  have  never 
l)een  observed. 

Treatment. — Nocard  recommends  naphthol  1  part,  ether  sulphuric  3 
parts,  and  olive  oil  10  parts.  This  should  l)e  injected  into  the  external 
auditory  canal  once  daily,  and  the  ear  plugged  up  with  cotton  to  prevent 
the  escape  of  the  ether.     The  latter  procedure  is  not  advisable,  for  if  the 


440  DISEASES  OF  THE  EAR 

ether  is  confined  in  the  ear  it  causes  great  irritation,  and  the  author  has 
found  from  experience  where  he  has  followed  this  procedure  that  while  he 
may  not  have  observed  epileptiform  fits  before  the  treatment,  he  has  had 
symptoms  simulating  them  very  much  after  the  ear  was  injected  with 
ether  and  the  cotton  plug  put  into  it. 

Sewell  advises  the  application  of  the  following  liniment: 

I^.        Ung.  hydrarg.  nit.,  4.0 

Oleum  airiygd.,  32.0 

M.  S.  Apply  a  small  amount  to  the  inner  surface  of  the 
ear  with  a  camel's  hair  pencil. 

The  ear  should  be  first  cleaned  out  with  wood  alcohol,  and  then 
apply  the  above. 


DISEASES  OF  THE  SKIN. 

INFLAMMATORY  CONDITIONS  OF  THE  CUTANEOUS  MEMBRANE. 

Inflammatory  symptoms  of  the  skin  vary  according  to  their  intensity, 
character,  or  location.  The  slightest  irritation  may  produce  redness, 
either  with  or  without  swelling — this  is  defined  as  erythematous  inflam- 
mation; or  we  may  have  a  formation  of  circumscribed,  solid,  firm  pro- 
tuberances, papillae,  pustules,  boils,  or  granulations.  These  are  ascribed 
to  exudations  originating  partially  in  the  papillary  body,  in  the  Malpighian 
membrane,  and  also  in  the  neighborhood  of  the  follicles. 

The  inflammatory  exudation  may  become  reabsorbed  in  certain 
cases,  so  that  after  the  acute  period  of  the  disease  has  passed,  the  epidermis, 
which  has  become  loosened,  is  gradually  desquamated  in  the  form  of 
scabs  or  crusts.  We  also  occasionally  see  a  dark  pigmentation  after  the 
disease  has  run  its  course.  This  originates  from  the  haemoglobin  of  the 
extravasated  red  blood  corpuscles.  If  the  inflammatory  processes  and 
exudations  increase  gradually  in  the  cutaneous  tissue,  we  may  observe 
two  different  results.  The  inflamed  location  may  become  covered  with 
a  moist,  liquid  exudation,  or  the  horny  layer  of  the  epidermis  is  raised  up 
by  the  fluid,  and  we  may  have  vesicles  which  raise  the  granular  layer  of 
the  mucous  strata,  and  also  the  deeper  layer  of  the  membrane  becomes 
destroyed  in  the  affected  region.  In  the  first  case  it  is  covered  by  the 
deep  layers  of  the  membrane;  in  the  latter  case  the  upper  surface  of  the 
corium  is  exposed,  having  lost  its  vesicular  covering. 

The  liquid  w^hich  fills  the  small  or  large  vesicles  is  deficient  in  cells 
in  the  early  stages  of  its  formation,  and  the  liquid  is  clear  or  slightly 
yellow.  Later  it  becomes  turbid  by  the  addition  of  leukocytes,  and  a 
number  of  whitish-yellow  cells  fill  the  fluid.  In  some  cases  it  has  this 
appearance  from  the  very  onset.  When  the  liquid  contained  in  the 
vesicle  is  yellow  and  filled  with  cells  it  is  called  a  pustule.  Sooner  or 
later  the  covering  of  the  pustules  becomes  ruptured,  and  the  fluid  dries 
up  in  a  yellow,  gray,  or  brown  crust,  under  which  the  regeneration  of  the 
lost  epidermic  layer  goes  on  rapidly. 

Now  and  then  the  inflammatory  process  shows  it  Is  in  the  neighbor- 
hood of  a  follicle  and  its  sebaceous  glands,  and  we  have  the  formation  of 
a  dark  red,  very  sensitive  nodule,  and  finally  suppuration  of  the  same 
membrane  and  its  adjacent  tissues.     As  a  consequence  of  this  we  find 

441 


442  DISEASES  OF  THE  SKIN 

that  the  glands  and  canal  of  exit  are  filled  with  purulent  or  bloody  matter. 
Soon  the  internal  follicles  become  involved;  the  masses  of  matter  can  be 
easily  pressed  out  of  the  orifice  of  the  follicle,  and  we  may  have  an  elas- 
ticity of  the  purulent  cavity  surrounded  by  infiltrated  cutis  in  which  we 
find  the  hair  has  become  entirely  detached  from  the  follicle  and  falls  out. 
This  condition  is  generally  a  rather  serious  affection  in  the  dog,  as  in  this 
animal  there  are  always  several  follicles  which  are  accumulated  into 
one  group  with  a  common  orifice,  and  in  every  case  of  cutaneous  disease 
we  find  a  group  of  affected  sebaceous  glands. 

In  very  bad  cases  peri-glandular  and  peri-follicular  inflammation 
may  become  so  acute  that  we  see  the  formation  of  an  extended  nodule- 
shaped,  dark  red  swelling,  forming  a  so-called  "boil."  This  is  marked 
after  a  certain  period  by  a  yellowish-green,  necrotic  thrombus,  which 
becomes  detached  by  purulent  disintegration  of  the  surrounding  tissue, 
and  is  sloughed  after  the  pus  has  been  discharged.  In  such  cases  we 
find  that  not  only  is  the  external  surface  of  the  skin  impaired,  but  the 
corium  is  affected,  and  as  the  follicles  are  destroyed  the  hair  does  not 
return.  The  formation  of  abscesses  and  ulcerations,  also  inflammations 
of  the  skin,  will  be  discussed  further  on. 

In  chronic  cutaneous  inflammation  we  may  see  the  formation  of 
hypertrophic  as  well  as  atrophic  conditions.  In  the  former  case  we  find 
as  a  consequence  of  the  constant  increase  and  congestion  of  blood  in  the 
part  the  formation  of  sui^erfluous  connective  tissue,  whereby  the  skin 
may  be  thickened  several  times  its  normal  size  and  may  form  large  folds 
or  collosities,  and  in  rare  cases  club-shaped  or  warty  elevations.  In  the 
latter  case  the  corium  becomes  thinner.  This  is  also  the  case  with  the 
epidermis.  Its  tissue  is  either  greatly  reduced  or  greatly  increased  in 
size,  and  in  the  latter  case  the  epidermic  cells  which  proceed  from  the 
deep  part  of  the  tissues  do  not  undergo  any  horny  degeneration,  but 
rather  a  drying,  mummifying  process,  covering  the  membrane  in  the 
shape  of  numerous  whitish  or  white-gray  scabs. 

NON-PARASITIC  DISEASES  OF  THE  SKIN. 

Erythema. 

{Redness  of  the  Skin.) 

Erythema,  due  to  disorders  of  the  circulation,  is  the  mildest  form 
of  inflammation  of  the  cutaneous  membrane  and  consists  either  of 
normal  hypera>mia  of  the  corium  in  its  upper  layers  (erythema  simplex, 
erythema  congestivum) ,  or  it  may  be  due  to  a  slight  sero-cellular  infiltra- 
tion of  the  membrane  of  Malpighi — erythema  exudativa  (dermatitis 
erythematosa). 


ERYTHEMA  443 

Etiology. — Erythoma  is  a  local  irritation  of  the  skin  and  originates 
as  the  result  of  various  external  cutaneous  irritations  "which  may  be 
mechanical,  chemical,  or  thermic — for  instance,  animals  with  thick, 
■\vooly  coats,  having  their  coats  cut  short  or  shaved  to  the  skin;  from 
irritation  of  the  skin  between  the  toes,  caused  by  running  through  sand; 
by  friction  of  the  collar  upon  the  skin  of  the  neck;  bathing  in  strong 
creolin  mixtures — coal  oil,  benzine^ — lyiiig  on  rough  boards;  bites  of  in- 
sects; on  the  abdomen  from  ammoniacal  urine  (in  catarrh  of  the  bladder) ; 
in  catarrh  of  the  prepuce,  and  by  slight  burning  or  freezing.  Erythema 
may  also  appear  in  connection  with  various  cutaneous  diseases,  such  as 
eczema,  scab,  and  canine  varioloid,  and  the  presence  of  an  enormous 
number  of  fleas. 

Clinical  Symptoms  and  Course. — The  symptoms  consist  of  a  bright 
arterial  redness  of  the  cutaneous  membrane,  which  disappears  under 
pressure  of  the  finger,  but  reappears  immediately  after,  and  may  be 
complicated  in  some  cases  by  slight  swelling  of  the  epidermis.  As  a  rule, 
the  affected  portion  is  reddened,  but  not  irritable,  although,  as  a  rule, 
the  animal  evinces  pleasure  on  gentle  rubbing  of  the  skin.  The 
course  is  usually  short,  depending  to  a  large  extent  on  the  cause.  When 
this  is  suppressed  or  removed,  especially  after  the  itcliing  and  rubl^ing 
have  discontinued,  erythema  disappears,  and  in  certain  conditions  it  is 
followed  by  desquamation  of  the  upper  membrane.  There  is,  however, 
a  more  or  less  dark  red  spot  left  after  the  acute  symptoms  of  the  disease 
have  lessened.  These  finall}^  disappear,  but  very  slowly.  This  is  par- 
ticularly noticeable  when  the  irritation  is  due  to  preputial  secretion  or 
ammoniacal  urine. 

Therapeutic  Treatment. — There  is  not,  as  a  rule,  any  great  irritation. 
It  will  be  sufficient  to  remove  the  cause  in  order  to  remove  the  erj-fhema. 
If  there  is  a  certain  amount  of  irritation,  we  must  lessen  it  by  bathing 
the  animal  with  lime  water  and  sponging  the  affected  parts  with  any  of 
the  following  solutions:  lead-water;  solutions  of  alum;  bay  rum;  cologne; 
benzoin  1  part,  alcohol  30  parts;  ichthyol  or  salicylic  acid  soap;  rublnng 
with  salicylic  oil  (1  part  of  salicylic  acid  dissolved  in  35  to  40  parts  of 
olive  oil  and  heated  slightly) ;  or  a  mixture  of  1  part  of  glycerine  and  5 
parts  of  water;  or  1  part  of  carbolic  acid,  10  of  alcohol,  10  of  water;  or 
4  parts  of  creolin,  100  of  water;  or  1  part  of  ichthyol,  10  of  glycerine,  30 
of  water;  or  10  parts  of  nitrate  of  silver,  100  of  water  (Friedberger) . 
Frecjuent  dustings  of  talcum  powder  is  one  of  the  most  efficient  remedies. 

In  very  obstinate  cases  we  may  also  use  laxatives  or  purgatives 
(aloe,  jalap,  salines,  etc.),  also  the  internal  administration  of  arsenic  in 
the  form  of  Fowler's  or  Donovan's  solution. 


444  DISEASES  OF  THE  SKIN 

Urticaria. 

{Nciile-rash.) 

This  disease  is  an  acute  irritation  of  the  skin,  indicated  by  the 
formation  of  circumspect  elevations  from  one  to  one  and  a  half  inches  in 
diameter,  and  due  to  a  vasomotor  neurosis  (angioneurosis)  of  the  skin. 

Etiology. — This  disease  is  comparatively  rare,  and  except  where 
we  can  trace  it  as  being  due  to  some  known  external  irritation,  such  as 
stings  of  insects — leptus  autumnalis — or  turpentine.  The  real  cause  of 
the  majority  of  cases  of  urticaria  is  not  understood,  being  due  to  some 
internal  irritation,  the  cause  of  which  is  unknown.  This  is  classed  under 
the  general  head  of  idiopathic  urticaria.  In  the  majority  of  cases  it 
certainly  is  due  to  some  disorder  of  the  intestines  (catarrh  of  the  intes- 
tines, constipation,  etc.),  and  it  is  supposed  that  faulty  assimilation 
caused  the  admission  into  the  circulation  of  certain  toxic  substances 
which  get  into  the  circulation  and  are  eliminated  by  the  skin,  causing 
local  irritation.  Schindelka  saw  a  mastiff  bitch  which  was  affected 
with  vaginal  catarrh  and  condylomas  of  the  vagina  and  accompanied 
by  general  urticaria,  and  also  saw  the  same  condition  in  a  poodle  bitch, 
during  her  period  of  heat.  Urticaria  may  also  follow  rapid  cooling  after 
the  animal  has  been  in  a  great  state  of  excitement.  It  has  also  been  seen 
during  dentition  of  the  permanent  molars. 

Clinical  Symptoms  and  Course. — The  manifestations  of  nettle-rash 
generally  show  themselves  without  any  previous  fever  or  other  phenom- 
ena, such  as  want  of  appetite,  depression.  There  appear  over  the  entire 
body  circumspect  flat  hemispherical  elevations,  varying  in  size  from  a 
pea  to  a  large  bean,  on  which  the  hair  is  ruffled  and  staring.  When  two  of 
these  elevations  become  confluent  the  elevations  are  much  larger;  the 
skin  may  be  itchy,  but  this  is  rare.  The  course  is  rapid,  frequently 
twenty-four  hours  after  the  eruption  appears  the  rash  has  entirely  dis- 
appeared, but  occasionally  a  new  crop  of  elevations  appears  or  the  disease 
may  take  a  chronic  course  (urticaria  chronica) ,  but  this  is  only  in  very 
rare  instances.  The  eruption  may  last  for  a  number  of  days,  and  when  it 
disappears  it  leaves  a  peculiar  pigmentation  of  the  skin,  Schindelka  has 
called  this  urticaria  pigmentosa. 

Treatment. — In  the  acute  cases,  the  condition  disappears  before 
treatment  can  be  of  use.  In  slower  cases,  as  a  rule,  saline  laxatives, 
saturated  solution  of  sulphate  of  soda,  Hunyadi  Janos,  Apenta;  and  when 
there  is  itching  use  some  of  the  local  preparations  recommended  in 
erythema. 


ECZEMA  445 

Eczema. 

{Red  Mange.) 

By  this  Ave  mean  fat  mange,  summer  mange,  phagedenic  scab,  scale 
scab.  It  is  a  cutaneous  disease  which  appears  in  all  breeds;  it  is  non- 
contagious and  is  an  inflammatory  condition  of  the  cutaneous  membrane 
indicated  by  redness,  swelling,  nodules,  pustules,  fissures,  scabs,  and 
crusts,  which  are  generally  accompanied  with  more  or  less  itching.  In 
the  first  stages  development  of  a  hyperaemia  is  seen,  thus  reddening  the 
skin  superficially,  and  accompanied  by  a  serous  exudation.  If  the  inflam- 
matory irritation  stops,  or  if  proper  therapeutic  measures  are  taken, 
recovery  may  occur  at  once,  and  we  have  a  more  or  less  prolonged  desqua- 
mation of  the  epidermis.  In  the  majority  of  cases,  however,  the  irritation 
increases  and  we  find  the  formation  of  numerous  pale  red,  tough,  itching 
nodules,  accompanied  by  serous  swellings  and  slight  cellular  infiltration 
of  the  papilla},  but  generally  it  is  connected  with  the  cutaneous  follicles. 
This  condition  may  become  retrogressive;  the*  nodules  become  depressed, 
forming  scabs.  In  other  cases  the  serous  exudation  increases  constantly 
inside  the  papule,  and,  as  a  consequence,  we  have  a  rising  of  the  external 
cutis  in  these  locations;  or,  in  other  words,  numerous  vesicles  are  formed 
(eczema  vesiculosum) .  If  the  external  cutis  is  strong  enough  to  resist  the 
accumulated  exudation  for  some  time,  the  contents  of  the  vesicles  grad- 
ually become  milky  and  pus-like,  on  account  of  the  entrance  of  colorless 
blood-cells  into  the  tissues  (eczema  pustulosum). 

In  other  cases  the  vesicles  burst  or  are  scratched  open;  the  skin  is 
dark  red  in  large  blotches,  and  is  marked  by  fine  furrows  which  corre- 
spond with  the  location  of  the  ruptured  vesicles.  The  eczematous  exu- 
dation oozes  freely  out  of  the  upper  surface  (eczema  rubrum).  It  is  a 
common  occurrence  to  see  the  detachment  of  small  portions  of  tissue 
which  are  located  between  the  numerous  furrows  in  the  epidermis. 
Thus  the  whole  surface  of  the  skin  is  stripped  of  its  ornyh  layer  and 
may  become  filled  with  pus.  The  oozing  liquid  dries  rapidly  and  be- 
comes a  scab  or  crust  (eczema  impetiginosum) ,  which  is  pushed  away 
gradually  by  the  consecutive  exudation,  and  finally  becomes  hard,  dry, 
and  firm.  Inflammation  and  swelling  become  gradually  lessened  under 
the  crust,  and  we  have  the  formation  of  a  firm  epidermic  cover,  from 
which  the  crusts  gradually  become  detached.  The  diseased  membrane, 
which  is  now  exposed,  is  not  swollen  to  any  great  extent,  but  very  red 
(sometimes  marked  with  dark,  livid  pigmentations)  and  covered  with 
numerous  loose  scabs  which  constantly  fall  off  and  are  renewed  from  time 
to  time  (eczema  squamosum). 

Etiology. — The  etiology  of  eczema  is  of  great  importance  for  es- 


446  DISEASES  OF   THE  SKLY 

tablishing  the  correct  prognosis,  as  no  cure  can  be  obtained  until  after 
the  cause  of  the  trouble  is  removed.  The  first  thing  we  must  do  is  to 
lessen  the  mechanical  irritations,  such  as  appear  under  the  collar  and 
on  the  testicles.  But  the  lesions  which  the  patient  inflicts  upon  himself 
are  of  very  much  more  importance,  for  we  see  it  in  all  forms  of  itching 
eruptions  of  the  skin,  in  erythema,  in  cases  of  parasites  of  the  cutaneous 
membrane — flies,  lice,  acari — ^in  great  accumulations  of  dirt,  scabs,  and 
falling  out  of  the  hair.  "We  also  find  attacks  of  eczema  which  extend 
very  fast,  and  in  some  cases  may  go  all  over  the  body. 

As  regards  the  second  group  of  agents  which  cause  eczema,  they 
are  chemical  irritants,  especially  those  which  have  an  influence  upon  the 
tissues,  such  as  acids,  alkalies,  mixtures  of  mercury,  also  tar  and  car- 
bolic salves,  combinations  of  ether  and  oil  of  turpentine,  of  mustard, 
and  also  tar-soap. 

The  third  group  is  formed  by  a  number  of  thermic  irritations, 
namely,  excessive  high  temperature,  but  not  high  enough  to  produce 
vesicles. 

Eczema  appears  more  frecpently  in  summer  than  in  winter,  and  we 
have  a  great  deal  more  difficulty  in  healing  it  during  the  summer  weather. 
We  also  have  a  number  of  eczematous  formations  for  which  we  can  find 
no  cause.  In  such  cases  the  disease  has  been  ascribed  to  acids  in  the 
blood  or  diseases  of  the  nervous  apparatus,  and  also  to  vegetable  para- 
sites, and  as  the  sensible  perspiration  in  the  dog  is  so  slight,  it  is  very  apt 
to  cause  irritation  when  the  skin  becomes  congested,  checks  the  secretion 
of  the  glands  and  retains  the  natural  excretions.  There  is  no  doubt 
that- various  fermentative  and  toxic  processes  occurring  in  the  intestinal 
tract  are  factors  in  the  production  of  eczema  rubrum,  and  that  dogs 
have  the  disease  annually,  and  associated  with  constipation.  Ep- 
pinger  contends  that  too  much  meat  is  not  the  actual  cause  as  he 
has  cases  where  the  animal  has  had  moist  itching  eczema  and  treated 
the  animal  with  various  drugs  without  result,  and  finally  gave  the 
animal  a  meat  diet,  and  in  two  weeks  the  animal  was  entirely  recovered. 
This,  however,  must  have  been  an  individual  case  as  experience  is  that 
a  strong  meat  diet  is  invariably  one  of  the  causes  of  this  disease. 

Clinical  Symptoms  and  Course. — Eczema  may  appear  in  any  breed 
of  dogs  and  in  any  region  of  the  body  without  regard  to  age,  sex,  etc. 
It  is  usually  seen  on  certain  regions  of  the  body  (back,  head,  neck,  and 
external  surface  of  the  extremities). 

There  are  three  general  forms  of  eczema  without  taking  into  con- 
sideration the  changes  which  may  be  produced  by  irritation,  scratching, 
or  rubbing. 

(1)  Acute  Moist  Eczema. — This  may  develop  year  after  year  and 
in  dogs  of  all  breeds.     The  longer  haired  clogs  seem,  however^  to  be  more 


ECZEMA 


447 


liable  to  it.  It  affects  certain  localities  of  the  body  more  than  others — 
the  neck,  jaws,  elbow,  on  the  back  anterior  to  the  tail,  and  the  outside 
of  the  thigh.  The  first  type  is  restricted  to  small,  irregularly  circum- 
scribed regions,  but  has  a  tendency  to  extend  to  the  neighboring  tissues. 
The  eruption  begins  as  eczema  papulosum  with  close  nodules.  The  skin 
becomes  red  in  irregularly  circular  patches  varying  in  size  from  a 
quarter  (shilling)  to  the  palm  of  the  hand  (Fig.  158);  there  is  increased 
heat  and  the  skin  thickens,  the  hair  stands  up,  and  soon  a  number  of 
small  vesicles  are  seen,  which  burst  and  discharge  a  pale  yellow  viscid  fluid, 
and   in   from  twelve  to  twenty-four  hours  there  is  partial  or  complete 


Fig.  158. — Moist  eczema  of  the  shoulder,  and  muzzle  to  jjrevent  the  animal  biting  it. 

loss  of  hair.  This  rapidly  changes  into  the  vesicular  layer  by  alteration  of 
the  nodule,  and  finally  we  see  the  appearance  of  the  median  stage. 
This  has  a  more  or  less  extended  surface  without  skin  or  hair,  and  shows 
a  bright  red,  serous,  sero-fibrinous  or  purulent  exudate,  very  painful 
to  the  touch,  and  having  a  great  tendency  to  extend  to  the  adjacent 
tissues  (phagedenic  scab).  The  stage  of  crustation  follows  A^ery  slowly; 
the  exudate  dries,  forming  a  yellow-green  to  brownish  crust  which  is 
firmly  fixed  to  the  skin  and  if  not  rubbed  by  the  animal  forms  a  thick 
scab  that  may  fall  off  in  a  few  days,  but  generally  it  is  two  or  sometimes 
three  weeks  before  it  finally  comes  off,  leaving  a  glossy,  hairless,  deep 
red  or  pigmented  surface,  with  more  or  less  gray  scales.  The  surface 
soon  becomes  covered  with  fine  hair,  which  soon  grows  very  rapidly, 
covering  the  spot  very  quickly.     This  termination  is  frequently  altered 


448 


DISEASES  OF  THE  SKIN 


by  the  animal  scratching,  biting  or  gnawing  the  itchy  surface,  particu- 
larly when  the  sore  is  on  the  side  where  the  animal  can  scratch  it  with 
the  hind  legs,  or  on  the  thighs  or  back  where  he  can  bite  it.  In  rare  in- 
stances the  animal  may  so  lacerate  the  affected  portion  as  to  cause 
permanent  loss  of  hair.  The  course  of  this  disease  depends  on  whether 
it  is  treated  early,  for  if  neglected  its  course  is  apt  to  be  slow  or  it  is 
apt  to  degenerate  into  the  chronic  form,  particularly  in  older  animals. 

Chronic  Eczema.     Dry  Eczema.     Scab  Mange. — The  second  type 
shows  from  the  beginning  an  inclination  to  extend.     In  is  generally 


Fig.  159. — Chronic  eczema  of  the  back. 

observed  in  sluggish,  well  nourished  dogs,  and  while  it  may  occur  in  all 
breeds  of  dogs,  it  is  more  apt  to  be  seen  in  short-haired  dogs.  It  com- 
mences on  the  back  at  the  root  of  the  tail  and  extends  gradually  up  the 
centre  of  the  back,  each  succeeding  attack  going  a  little  further  forward 
until  it  finally  reaches  the  neck.  It  is  sometimes  observed  at  the  base 
of  the  ear,  around  the  anus  and  the  extremities;  the  scrotum  is  also  a 
seat  of  the  disease,  and  in  exceptional  cases  the  entire  body  is  attacked 
(general  eczema). 

In  the  early  stages  we  see  it  as  eczema  erythematosum  with  for- 
mation of  scattered  papules.     These  are  scratched  open  on  account  of  the 


ECZEMA  449 

great  itching  they  cause,  or  they  become  altered  into  pustules.  Later 
we  see  the  appearance  of  small  scabs  under  which  regeneration  of  the 
epidermis  occurs,  the  hair  falls  off  or  frequently  long  solitary  hairs  are 
found,  the  skin  is  thickened,  developing  wrinkles,  crevices  which  fre- 
quently are  raw,  and  the  surface  dull,  lead  colored,  ''elephant  hide" 
in  appearance  (Fig.  159).  In  the  other  regions  desquamation  of  the 
epidermis  follows,  particularly  in  summer;  the  animal,  from  the  intense 
itching,  scratches  and  tears  the  skin,  converting  the  entire  surface  into  a 
raw  bleeding  space  with  spots  of  pigmentation.  There  is  more  or  less 
itching,  but  the  irritation  is  not  nearly  so  great  as  in  sarcoptic  mange, 
and  is  limited  to  the  affected  skin. 

In  chronic  eczema  the  condition  gradually  creeps  up  the  back, 
becoming  broader  and  assumes  a  dull  dark  lead  colored  ''elephant  hide" 
look,  with  long  unhealthy  hairs  here  and  there,  or  else  this  condition 
may  prevail  during  the  summer  months,  defying  all  forms  of  treatment, 
and  when  the  cool  autvimn  months  come  the  irritation  gradually  sub- 
sides, the  hair  begins  to  return,  becomes  thick  and  normal  by  January 
or  February  and  remains  so  until  July  or  August  comes,  and  the  con- 
dition returns. 

The  following  is  a  list  of  remedies  useful  in  eczematous  eruptions: 

Ichthyol  ointment,  2  to  5  per  cent.,  with  equal  parts  of  lanolin  and 
cosmoline. 

Ichthyol  tar-soap  moistened  and  rubbed  on  the  itching  parts  and 
allowed  to  dry. 

Permanganate  of  potash  solution  of  the  strength  of  1  to  3  per  cent, 
where  the  skin  is  peculiarly  irritable. 

Where  the  surfaces  are  widespread  and  moist,  dust  with  equal  parts 
of  talcum,  lycopodium,  and  boric  acid. 

For  use  in  the  house  on  pet-dogs  that  have  the  range  of  the  parlor 
and  lounge  on  the  rugs  and  furniture,  try  a  15  per  cent,  solution  of 
hyposulphite  of  soda. 

Creolin  baths  of  the  strength  of  5  per  cent,  will  give  very  great  relief 
for  many  hours. 

In  the  finer  toy  varieties,  try  a  1  per  cent,  solution  of  trikrcsol;  ten 
grains  of  boric  acid  to  the  ounce  of  this  solution  adds  to  its  efficacy  in 
some  cases. 

Chloro-naphtholeum,  two  ounces  to  the  gallon  of  water,  is  a  useful 
medicated  bath  for  the  large  varieties  of  dogs,  and  is  destructive  to 
parasitic  forms  of  life. 

Trikresol  soap  is  far  safer  and  better  than  carbolic  acid  soap  for 
bath  purposes  when  washing  dogs  frequently. 

Do  not  use  bichloride  of  mercury  solutions  in  moist  eczema. 

Starch  and  oxide  of  zinc  may  be  used  separately  or  in  combination 
29 


450  DISEASES  OF  THE  SKIN 

as  a  dusting-powder  alone,  or  after  any  of  the  watery  solutions  and 
tend  to  hasten  healing  of  broken  or  denuded  parts. 

In  chronic  and  long-standing  cases,  where  fissures  of  the  skin  have 
formed  and  the  animal  tends  to  bite  the  affected  parts,  causing  bleeding, 
touch  them  a  few  times  with  Monsel's  solution  of  iron,  and  then  use  one 
of  the  powders. 

For  softening  the  parts,  equal  portions  of  lanolin  and  pure  cosmoline, 
with  ten  per  cent  of  ])oric  acid,  will  be  found  useful  and  cleansing. 

Itching  of  the  Skin  Without  Presence  of  a  Rash. — This  condition  may 
extend  over  the  entire  boily  or  it  may  be  limited  to  the  back  or  abdo- 
men, or  the  internal  surface  of  the  thigh.  Frequently  there  is  intense 
itching,  with  little  or  no  evidence  of  change  in  the  skin.  The  skin  ap- 
pears red  in  some  cases  with  only  the  slightest  evidence  of  papules.  In 
some  cases  the  animal  will  scratch  constantly,  and  at  night  the  itching 
is  apt  to  be  particularly  violent  (this  is  seen  generally  in  animals  that 
are  particularly  well  fed,  house  pets  that  are  bathed  often) .  They  scratch 
their  sides  with  the  paws,  bite  different  portions  of  their  anatomy  with 
the  teeth,  and  rub  under  or  against  furniture  until  there  is  great  irrita- 
tion of  the  skin.  A  similar  condition  is  also  seen  in  dogs  that  have  been 
clipped,  and  the  short  stubby  hairs  sticking  in  the  folds  of  the  skin  cause 
great  irritation,  l)ut  in  this  condition,  while  the  itching  is  intense  just 
after  the  animal  is  clipped,  in  a  short  time  the  hair  grows  and,  becoming 
more  flexijjle,  does  not  cause  irritation  and  the  itching  soon  disappears. 

Seborrhoeic  Eczema.  Eczema  Seborrhoeicum. — This  generally  origi- 
nates from  a  seborrhoea  sicca;  it  may  be  local  or  general,  and  is  distin- 
guished by  a  number  of  eczematous  calculse  or  oval  disks  which  are 
either  solitary  or  in  groups,  each  elevation  being  clearly  outlined  from  the 
other.     There  is  no  itching,  as  a  rule,  and  if  there  is,  it  is  insignificant. 

Eczema  of  the  Toes.  Interdigital  Eczema. — Eczema  between  the 
toes  is  quite  common.  It  is  apt  to  occur  in  well-fed,  well-taken-care-of 
house  pets,  and  also  a  certain  numlier  of  cases  originate  from  actual 
external  influences,  such  as  sporting  dogs  in  the  field  working  through 
stubble,  short  grass  and  weeds;  generally,  however,  it  is  due  to  good 
feeding  and  want  of  exercise,  and  may  occur  in  any  of  the  various  forms — 
eczema  vasculosum,  eczema  medidans,  or  eczema  pustulosum. 

Therapeutic  Treatment. — In  the  treatment  of  eczema  we  must  con- 
sider the  following  facts: 

(«)  That  in  many  cases  the  tar  preparations  which  have  been 
used  almost  exclusively  are  very  harmful,  as  is  also  the  method  of 
systematically  washing  the  animal  with  strong  alkaline  or  carbolic 
soaps.  The  first  thing  to  do  is  to  give  attention  to  the  causes  and  find 
out  from  what  cause  the  itching  really  occurs,  as  many  cases  of  eczema 
disappear  as  soon  as  the  irritation  has  been  suppressed. 


ECZEMA  451 

We  must  first  remove  any  cause  of  irritation  that  would  tend  to 
aggravate  the  condition — such  as  dust,  scales  off  dandruff,  parasites — or 
anything  that  would  tend  to  prolong  the  condition.  Filthiness  of  the 
skin  and  hair  nuist  be  removed  by  bathing  the  animal  thoroughly, 
taking  care  to  use  a  clean  superfatted  soap  that  does  not  contain  too 
much  alkali,  and  particularly  avoid  various  soaps  that  contain  crude 
carbolic  acid  or  the  irritating  coal-tar  products,  so  frequently  seen  in 
the  ''dog  soaps"  sold.  It  must  he  borne  in  mind,  however,  that  too 
frequent  bathing  is  apt  to  act  as  an  irritant  in  eczema  and  while  it  should 
be  used  to  remove  dirt,  it  must  not  be  used  frequently,  but  as  an  actual 
necessity.  In  acute  squamous  eczema,  the  irritated  spots  can  be  dried 
up  by  pressing  absorbent  cotton  on  the  sore,  which  has  been  saturated 
with  carbolized  oil,  lime  w^ater,  boracic  acid  solution,  creolin  solution, 
acetate  of  alum,  or  thiol  mixed  with  corn  starch.  In  the  acute  form  of 
eczema  the  hair  should  be  clipped  not  only  over  the  affected  parts,  but 
also  cut  a  clear  space  in  the  tissues  surrounding  the  sore.  Excessive 
scratching  must  be  avoided  by  putting  on  muzzles,  bandages  or  covers  over 
the  body,  or  chamois  boots  on  the  hind  legs,  etc.  Finally,  care  must  be 
taken  to  prevent  the  animal  licking  off  the  medicine,  which  may  either 
act  as  an  intestinal  irritant,  or  actually  poison  the  animal;  with  the  addi- 
tion of  muzzles,  the  means  already  mentioned  should  be  employed. 
We  dust  the  affected  parts  with  oxide  of  zinc,  cerussa,  sulphur,  or  thiol, 
talcum  powder,  corn  starch,  magnesia  containing  l)ismuth  subnitrate, 
dermatol;  salicylic  acid  in  talcum  powder  is  particularly  useful.  If  the 
affected  parts  are  very  moist,  they  may  be  dusted  with  lycopodium  or 
smeared  with  vaseline. 

In  cases  of  extensive  redness  of  the  skin  we  must  apply  compresses 
of  lead-water  or  thymol  (1  per  cent.),  creolin  (1  to  2  per  cent.),  carbolic- 
acid  water,  thiol  water  (20  per  cent,  thiol  liciuid,  30  per  cent,  glycerine, 
and  50  per  cent,  water);  and  where  the  skin  is  di-y,  an  ointment  of  sul- 
phate of  lime,  or  sugar  of  lead  in  lanolin,  dermatol  (1  to  5)  or  tannin 
(1  to  10);  but  powdering  is  preferable  as  every  skin  is  not  benefited  by 
liquid  or  oily  preparations  in  the  early  stages.  As  soon  as  the  marked 
symptoms  of  the  disease  have  decreased  we  may  replace  the  use  of 
powder  by  ointments  of  zinc  or  lead,  white  precipitate  ointment,  or 
cold  cream,  lanolin,  benzoin  and  glycerine,  and  benzoin  and  lanolin,  1  to 
30,  or  use  mild  ichthyol  soaps. 

(6)  In  very  moist  eczema  with  an  acute  course  the  use  of  powder  is 
not  always  successful.  In  those  cases  we  must  apply  drying  fluids, 
such  as  corrosive  sublimate  solution  (1  to  1000),  nitrate  of  silver  solution 
(2  per  cent.),  1  per  cent,  solution  of  picric  acid  twice  daily  by  means  of  a 
brush  or  cotton  tampon,  and  at  the  same  time  use  the  powders  already 
mentioned  in  conjunction  with  these  liquids.     Great  care  must  be  taken 


452  DISEASES  OF  THE  SKIN 

when  using  the  sublimate  to  avoid  poisoning,  also  the  application  of  both 
nitrate  of  silver  and  picric  acid  are  apt  to  leave  more  or  less  black  or  yellow- 
stain  on  the  skin.  Oxide  of  zinc  and  sugar  are  recommended  by  Bis- 
sauge,  to  be  dusted  on  several  times  daily.  Sublimate  ointments  (1  per 
cent.)  or  subiodide  of  mercury  (2  per  cent.)  are  beneficial,  but  strong 
solutions  of  blue-stone  or  crude  sulphate  of  iron  and  tormentilla  root  are 
not  to  be  recommended. 

I^.        Hydrarg.  l^ichlorid.,  1.0 

Glycerinum,  10.0 

Spts.  vini  rect.,  90.0 

F.  M. 
Sig. — To  apply  upon  eczematous  surfaces. 

^- 


Zinc  oxide, 

5.0 

Amyl.  pulv., 

Talc, 

aa  10.0 

F.  M. 

Sig. — Dusting  powder. 

Bismuth  subgallate, 

3.0 

Talc, 

20.0 

F.  M. 

Sig. — Dusting  powder  for 

moist 

eczema. 

^. 


(c)  In  cases  of  pustula  we  may  use  the  same  treatment  as  is  in- 
dicated in  b,  after  having  pressed  out  and  emptied  the  pustules.  The 
writer  has  also  obtained  good  results  v/ith  ichthyol  liniment  and  salicylic 
ointment  (see  Acne). 

(rf)  In  chronic  eczema,  when  it  has  reached  the  scaly  stage,  we  must 
first  clean  the  skin  thoroughly  with  some  mild,  non-irritating  soap,  but 
not  carbolic  or  tar  soap.  The  best  kind  to  use  is  Castile,  ivory,  green 
German  soap,  or  the  pure  potash  soap  of  the  Pharmacopoeia.  The 
writer  has  had  good  results  from  "Hebra's"  alcoholic  potash  soap: 

I^.        Saponis  kalin.  venal.,  200.0 

Alcohol,  100.0 

Hebra's  soap  is  poured  or  rubbed  upon  the  surface  which  is  thickly 
covered  with  crusts,  and  on  the  following  day  they  are  removed  easily 
without  subjecting  the  animal  to  much  pain.  After  careful  cleansing 
we  use  the  same  agents  as  are  used  in  the  moist  forms  of  eczema — zinc 
powder,  corrosive  sublimate,  or  nitrate  of  silver. 

(c)  In  chronic  eczema,  we  use  tar  and  ichthyol  and  resorcin.  The 
first  is  used  either  in  the  form  of  solutions  of  tar  or  combinations  with 
oils.  These  preparations  are  used  with  good  results  in  the  chronic  forma 
of  eczema  where  there  is  considerable  cutaneous  thickening,  with  cracks, 


ECZEMA  453 

fissures,  etc.  Ichthyol  is  especially  useful,  and  when  used  in  concentrated 
form  in  ointments  or  liniments,  it  is  much  more  valuable  than  tar  prep- 
arations, because  it  relieves  the  itching  or  irritation  in  a  very  short 
time.  Its  high  price  bars  its  use  to  a  certain  extent  when  it  is  to  be  used 
in  a  kennel  of  dogs.  Resorcin  is  also  used  in  spiritous  solutions.  It  has 
the  disadvantage  of  staining  the  hair  of  light  colored  animals  yellowish- 
or  brownish-green,  wdiich  takes  a  long  time  to  wear  off.  In  chronic 
eases,  alcoholic  preparations  of  benzoin,  1  to  30,  are  very  useful,  to  be 
well  rubbed  into  the  skin  daily. 

I^.       Oleum  picis,  3.0 

Spts.  villi  rect.,  2.0 

Ether  sulphuric,  1.0 

F.  M.  S.— Rub  into  the  parts  every  third  day. 

I^.        Picis  Hquidse, 

Saponis  kalin.  venal, 

Spirit  dilut.,  aa  50.0 

Sig. — Apply  once  daily. 

T^.       Creolin, 

Sapo  kalin  venal,  aa  100.0 

Spts.  vini  rect.,  50.0 

F.  M. 

Sig. — Rubbed  in  daily.     (Frohner.) 

I^.       Ammon.  sulfo-ichthyolic,  12.0 

Aqua  calcarise, 

Oleum  olivarum,  aa  60 . 0 

Sig. — Apply    upon    the    thickened    membrane    once 
daily.     (Frohner.) 


^■ 


n 


Resorcin, 

3.0 

Spts.  vini  rect.  dil., 

120.0 

F.  M. 

Sig. — Rub  into  skin  daily. 

Acid  salicylic, 

5.0 

01.  Fusci, 

25.0 

Sapo.  viridi, 

1.50.0 

Sig. — Soap  for  chronic  seborrhoeic  eczema. 

Acid  salicylic. 

3.0 

01.  olivae, 

100.0 

F.  M. 

Sig. — Rubbed  into  the  skin 

daily. 

That  form  of  eczema  described  under  the  head  of  itching  of  the 
skin  without  the  presence  of  papules  generally  resists  treatment.  Fre- 
quent bathing  with  the  various  strong  soaps,  sold  as  "dog  soaps"  con- 


454  DISEASES  OF  THE  SKIN 

taining  active  irritants,  such  as  tar,  crude  carbolic  acid,  and  various 
other  chemicals  supposed  to  destroy  fleas,  tends  to  irritate  the  skin  and 
increase  the  itching.  First,  the  blood  which  is  generally  too  rich  from 
overfeeding,  or  too  little  exercised,  must  be  purified  by  the  internal 
administration  of  salines,  such  as  a  tablespoonful  of  saturated  solution 
of  sulphate  of  soda  (giauber  salts),  once  daily,  or  the  same  amount  of 
Hunyadi  or  Apenta  water,  and  when  the  animal  is  bathed  it  must  be 
with  the  mild  superfatted  soap,  containing  little  alkali  and  some  soothing 
preparation,  such  as  benzoin  or  ichthyol.  Frequently  bathing  has  been 
found  to  aggravate  the  condition.  The  animal  should  be  rubbed  daily 
with  bay  rum,  spirits  of  camphor,  or  benzoin,  3  parts,  lanolin  1,  and 
alcohol  2  parts,  or  salicylic  acid  and  alcohol  (1  to  30),  or  resorcin  and 
lanolin  (1  to  50),  and  internally  the  regular  adminstration  of  some  of 
the  arsenical  combinations — sulphuret  of  arsenic,  1-200,  Fowler's  or 
.Donovan's  solution,  in  1-,  2-,  or  3-drop  doses.  These  arsenical  prepara- 
tions must  be  always  given  in  the  food,  for  when  given  on  an  empty 
stomach  are  very  apt  to  cause  vomiting;  at  the  same  time  the  animal 
must  be  exercised,  the  amount  of  meat  must  be  lessened  to  a  minimum, 
and  the  diet  be  soups  containing  vegetables  and  stale  hard  bread  or 
toast. 

(/)  If  there  is  considerable  thickening  of  the  skin,  and  if  the  latter 
is  covered  at  the  same  time  with  scabs,  we  can  obtain  good  results  by 
rubbing  salicylic  oil  (1  part  salicylic  acid  in  35  parts  of  warm  olive  oil) 
over  it  daily  for  a  week.  If  this  does  not  succeed,  which,  however,  is 
very  rare,  we  must  first  use  tar  or  ichthyol  preparations  and  follow  it  up 
by  the  other.  Some  authors  advise  friction  with  soft  soap,  chrysarobin 
ointment,  or  naphthalin,  and  washing  with  potash. 

For  internal  treatment,  use  saline  laxatives,  and  where  there  is 
general  disorder  of  the  digestive  tract,  such  as  gastro-intestinal  catarrh, 
constipation,  or  foetid  black  stools,  regulate  the  diet,  put  the  animal  on  a 
mixed  vegetable  and  meat  diet,  and  two  meals  daily.  The  amount  should 
be  just  as  small  as  possible  until  the  animal  regains  his  appetite;  in  fact 
w^ait  until  he  is  ready  to  eat  every  meal  when  it  is  offered,  before  putting 
him  back  on  his  regular  food.  Yeast  preparations,  such  as  brewer's 
or  baker's  yeast,  are  recommended  on  account  of  their  properties  for 
stimulating  the  intestines. 

Administer  arsenic  in  the  form  of  red  sulphuret,  1-200  grain,  or 
Fowler's  or  Donovan's  solution,  1,  2  or  3  drops  in  the  food  twice  daily. 
The  theory  that  the  gradual  increase  of  the  dose  of  arsenic  until  you  have 
reached  the  point  where  the  physiological  effects  were  beginning  to  show 
on  the  teeth,  vomiting,  etc.,  is  an  error.  Small  regular  doses  continued 
over  some  time  is  the  best  mode  of  treatment.  Care  must  be  taken, 
however,  not  to  start  on  too  large  a  dose. 


ACNE 


455 


Acne.  Furunculosis. 


Under  the  name  of  ''acne"  we  mean  an  inflamimation  of  the  hah-- 
follicles  and  sebaceous  glands  resulting  in  suppuration.  This  form  of 
skin  disease  is  not  produced,  however,  by  follicular  acari.  This  condition 
is  classed  as  folliculitis  or  perifolliculitis,  and  in  the  dog  is  regarded  as  a 
rather  grave  condition,  as  the  various  follicles  in  the  dog  are  freciuently 
connected  by  one  common  follicular  duct,  particularly  in  the  hair  bulbs 
where  they  have  a  very  complex  arrangement  with  the  sel)aceous 
glands,  and  the  irritation  of  one  duct  involves  the  whole  hair  bulb  and 
sebaceous  gland,  causing  extensive  elevations,  painful  nodules,  or  dark 
bluish-red  tumefactions  (furuncle,  dermatitis  furunculosa). 

This  condition  generally  appears  on  the  nose,  cheek,  side  of  the  face, 
external  fascite  of  the  extremities,  between  the  toes,  and  in  some  cases 
over  the  entire  body. 

Etiology. — ^"er3^  little  is  known  of  the  actual  cause  of  this  disease. 
Local  irritations  have  been  thought  to  be  the  cause,  such  as  constant 
pressure  of  the  muzzle,  licking  or  rubbing  the  affected  parts,  and  in  certain 
cases  to  some  hereditary  predisposition  due  to  alteration  in  the  character 
of  the  sebaceous  glands,  to  waste  products  or  pus  that  breaks  down  and 


Fig.  160. — Acne  of  the  nose. 


tends  to  encourage  the  growth  of  bacteria  which  invade  the  hair-follicles 
and  sebaceous  glands.  Dogs  affected  with  chronic  constipation  are  more 
liable  to  have  acne. 

Clinical   Symptoms   and  Prognosis. — This   disease  which  seems  to 


45G  DISEASES  OF  THE  SKIN 

attack  certain  portions  of  the  Iwdy  more  than  others,  particularly  on  the 
skin  of  the  snout  between  the  stop  to  the  nostril  (Fig.  100),  cheeks, 
side  of  the  skull,  and  between  the  toes;  more  rarely  on  the  outside  of 
the  legs,  and  in  exceptionally  rare  instances  it  extends  all  over  the  body, 
develops  very  slowly,  beginning  with  redness  and  loss  of  the  skin  and 
hair.  It  is  indicated  by  a  series  of  red  spots  which  are  painful,  irregular, 
swollen,  and  extend  over  the  surface  the  size  of  a  dollar  to  the  palm  of 
the  hand.  These  spots  are  caused  by  the  formation  of  a  large  number 
of  pea-like  nodules  which  are  hard  and  firm.  In  some  cases  we  find  the 
whole  surface  of  the  skin  red,  hard,  and  very  painful  to  the  touch.  After 
a  short  time  the  nodules  become  soft,  discharge  spontaneously  a  more 


Fig.   161. — Acne  muzzle. 

or  lesser  amount  of  bloody  pus,  and  contain  in  some  cases  cores  of  necrotic 
tissue. 

Occasionally  we  see  the  coalescence  of  a  number  of  these  acne  nodules, 
so  that  the  skin  presents  a  bluish-red  discoloration  and  becomes  purulent 
or  sometimes  necrosed,  as  if  the  skin  was  undermined  by  purulent 
collections.     This  may  appear  all  over  the  body. 

The  "non-acarian"  acne  often  presents  symptoms  similar  to  the 
parasitic  acne  (dermodectic  mange)  and  in  every  instance  it  is  always 
well  to  make  a  careful  microscopical  examination  of  some  of  the  pus 
sc^ueezed  out  of  nodules  to  see  if  any  of  the  acari  are  present.  It  has  a 
great  tendency  to  extend  in  almost  all  directions,  and  the  cicatrices 
which  appear  after  healing  of  the  disease  leave  bare  spots  in  different 
parts  of  the  body,  pink  in  color,  streaked  with  lines  of  black  pigment 
deposits. 

Therapeutic  Treatment. — The  treatment  consists  in  the  removal  of 
any  known  cause  of  the  disorder — when  the  disease  is  located  on  the  nose, 


ACNE  457 

which  is  one  of  the  commonest  locations  of  the  disorder,  due  to  pressure  of 
the  muzzle,  the  accompanying  figure  shows  a  muzzle  recently  put  on  the 
market  (Fig.  1(51),  which  obviates  the  pressure  on  the  nose,  the  ordinary 
nose  strap  being  replaced  by  a  snooth  metallic  arch.  The  ordinary 
muzzle  can  be  covered  b}^  ra^vhide,  leather  or  wadding  or,  better  still, 
the  portion  toward  the  nose  faced  with  patent  leather.  The  treatment 
consists  in  the  energetic  local  application  of  various  external  preparations. 
If  the  aeneous  nodules  are  in  the  early  part  of  their  development,  we 
must  puncture  them  or  open  the  follicles  by  some  strong  antiseptic,  such 
as  salicylic  or  balsam  of  peru  ointment.  In  cases  where  purulent  dis- 
integration has  gone  on  it  is  advisable  to  open  the  pustules.  This  is 
l)est  performed  by  means  of  a  small  bistoury  or  short  strong  needle, 
and  then  fill  in  the  opening  with  iodine  or  paint  it  with  disinfecting 
solutions,  such  as  pyroktanin  solution  (1  to  10  of  alcohol),  or  a  1  to  1000 
solution  of  corrosive  sublimate,  compound  tincture  of  benzoin,  or  dusted 
with  boracic  acid,  or  bismuth-formic-iodide.  This  should  be  used  once  a 
day  when  the  acne  is  developing. 

I^.       Acid,  salicylic,  20.0 

Oleum  olivse,  40.0 

Lanolin,  80.0 

Sig. — Put  a  small  portion  on  the  parts  once  daily. 

I^.       Naphthol,  -  10.0 

Sulphur  sub.,  50.0 

Ung.  petrolati, 

Sapo.  viridis,  aa  25.0 

F.  M. 
Sig. — Apply  daily. 

The  following  should  be  used  when  the  pustules  have  been  emptied : 

I^.       CreoHn,  1.0 

Acid,  boraci,  30.0 

F.  M. 
Sig. — Dusting  powder. 

Frohner  advises  curetting  the  cavities  and  the  use  of  the  creolin 
ointment  just  mentioned,  and  in  some  cases  cauterization  with  nitrate 
of  silver,  or  powdering  with  sulphonal  and  tannic  acid.  In  cases  of 
circumscribed  acne  it  is  advisable  sometimes  to  cut  out  the  diseased 
portion  of  the  skin. 

The  scales  or  scurf  must  be  removed  daily,  until  the  pus  is  cleared 
out  and  granulation  has  commenced,  then  encourage  the  formation  of  a 
scab  by  using  one  of  the  various  antiseptic  dusting  powders  or  the  daily 


458  DISEASES  OF  THE  SKIN 

painting  of  the  part  with  compound  tincture  of  benzoin,  until  a  thick 
scab  is  formed  which  protects  the  sores  while  healing  goes  on. 

Alopecia.     Falling  Out  of  the  Hair. 

By  this  term  we  mean  a  falling  out  of  the  hair  which  is  not  caused 
by  actual  disease  of  the  hair.  We  make  a  distinction,  however,  between 
general  alopecia  and  alopecia  areata.  The  former  is  an  extensive 
falling  out  of  the  hair,  often  recognized  after  serious  disease  and  during 
the  period  of  convalescence,  as  in  the  latter  stages  of  gestation  and  during 
and  after  nursing  a  large  litter.  The  latter  is  a  symptom  of  bad  nutritive 
condition  (alopecia  symptomatica),  and  is  characterized  in  some  cases 
by  a  circumscribed  or  rounded  herpes;  this  may  become  confluent  and 
is  especially  developed  on  the  back,  tail,  and  external  fascise  of  the  thighs. 
In  both  forms  it  is  not  rare  to  find  the  skin  pigmented.  Siedamgrotsky 
has  proved  that  alopecia  of  the  dog  if  circumscribed  or  diffuse,  depends 
on  the  atrophic  condition  of  the  hair  and  infiltration  of  the  upper  cu- 
taneous layers,  and  it  is  especially  seen  in  dogs  wdth  silky,  white  or  grayish 
hair.  Black-tipped  hair,  if  the  body  of  the  hair  is  gray,  is  also  notice- 
able. This  condition  is  very  apt  to  be  confounded  with  herpes,  in 
the  form  of  a  trophoneurosis,  either  from  a  disturbance  of  the  cir- 
culation, or  the  irritation  of  parasites. 

It  has  been  thought  that  certain  forms  of  this  disorder  might  be 
due  to  some  specific  microorganism,  but  it  has  not  been  as  yet  isolated 
and  described.  There  is  seen  in  two  breeds,  Pomeranians  and  York- 
shires, a  peculiar  condition  due  to  atrophy  of  the  hair  bulbs,  in  which 
young  clogs,  rarely  over  six  to  eight  months,  changing  from  the  puppy 
hair  to  the  first  coat,  loose  the  hair  gradually  or  it  falls  out  in  spots  or 
large  areas  become  bare,  invariably  one  side  of  the  body  being  in  perfect 
symmetry  with  the  other,  leaving  the  animal  permanently  bald  in  the 
affected  portions.  It  rarely  covers  over  the  entire  body,  but  is  seen  in  the 
hind  quarters  and  body  as  far  up  as  the  anterior  limbs.  The  skin  is 
bluish-black,  perfectly  smooth,  soft  and  pliable,  with  no  signs  of  erup- 
tion. That  it  is  due  to  some  pathological  change  in  the  central 
spinal  system  is  very  evident  as  there  is  a  perfect  symmetry 
of  the  affected  sides.  It  is  evidently  due  to  too  close  breeding,  when 
the  object  is  to  get  miniature  animals,  as  it  is  only  seen  in  these  toy 
breeds. 

Therapeutic  Treatment. — Find  the  cause;  if  any,  remove  it  by  treat- 
ment. The  treatment  consists  of  washing  with  alcoholic  soap,  bay  rum, 
benzoin  and  alcohol  (1  to  30) ,  and  a  diluted  tincture  of  cantharides  or 
balsam  of  Peru  with  alcohol,  1  to  10,  or  some  of  the  various  hair  tonics 
recommended  for  man.     In  alopecia  areata  when  it  is  possibly  due  to 


ALOPECIA  459 

vegetable   parasites,   we   should   use   the   treatment   recommended   for 
favus  and  herpes. 

I^.       Tincture  of  cantharides,  5.0 

Balsam  of  Peru,  •    10.0 

Spts.  vini  rect.,  100.0 

M.  D.  T. 

Sig. — Hair  tonic. 

It  is  advisable  in  alopecia  areata  to  use  antiparasitic  agents,  such 
as  diluted  tincture  of  iodine  (Friedberger  and  Frohner),  or  an  alcoholic 
salicylic  acid  (10  per  cent.).  The  principal  therapeutic  agents,  however, 
are  rubbing  with  a  strong  brush,  increasing  the  nutrition  of  the  skin, 
plenty  of  exercise,  and,  above  all,  patience. 

Pruritus  (Pruritus  Cutaneous). — This  is  an  anomaly  of  the  skin  in 
which  there  is  intense  itching  without  any  apparent  cause,  either  from 
parasites  or  visible  anatomical  alterations  of  the  skin.  In  man  a 
similar  condition  is  observed  in  icterus,  diabetes  mellitus,  chronic 
affection  of  the  kidneys  and  intestinal  tract;  also  from  the  administration 
of  some  medicinal  substances  or  certain  kinds  of  food.  It  is  also  seen  in 
old  age.  Intense  itching  has  been  observed  in  rabies,  from  the  presence 
of  large  numbers  of  intestinal  parasites  shown  by  anal  itching  (pruritus 
ani),  in  certain  affections  of  the  spinal  cord,  distemper,  neuritis,  disorders 
of  nutrition,  and  in  some  instances  no  true  cause  can  be  found.  Fre- 
quently old  dogs  that  have  been  extremely  healthy,  suddenly  begin  to  age 
rapidly  and  show  intense  itching  of  the  skin.  The  treatment  of  these 
nervous  conditions  depends  on  finding  the  true  cause  of  their  origin,  and 
treating  these  causes.  Where  it  is  due  to  unknown  causes,  consult  the 
chapter  under  the  head  of  itchiness  of  the  skin  without  the  formation  of 
papules. 

Prurigo  {itching  vesicles)  is  a  disease  of  the  skin  which  appears  at 
an  early  age.  It  is  generally  incural)le.  There  is  the  formation  of  a 
rash  which  is  intensely  itchy.  Sometimes  Ave  may  find  a  prurigo  exan- 
thema which  is  indicated  by  the  formation  of  numerous  nodules,  followed 
later  on  with  pigmentation  of  the  skin  and  tumefaction  of  the  lymphatic 
glands  (prurigo  bubo).  This  disease,  as  a  rule,  appears  only  in  young 
dogs,  commencing  with  an  eruption  similar  to  urticaria.  The  treatment 
consists  in  thorough  cleaning  with  mild  sulphur  soaps  and  sulphur,  tar, 
and  ichthyol  ointments. 

Seborrhoea  {Greasy  Skin). — This  disease  is  characterized  by  an 
extraordinary  secretion  of  the  sebaceous  glands.  We  find  two  forms, 
seborrhoea  oleosa  and  seljorrhcea  sicca  et  pitj'roidis.  These  two  forms 
may  both  be  present  in  fat,  overfed  dogs.  The  seborrhoea  sicca  is 
especially  found  in  long-haired  dogs,  like  poodles,  as  an  accompaniment 


4 GO  DISEASES  OF  THE  SKIN 

of  eczema.  More  rarely  it  is  found  following  distemper.  It  appears 
1)ehind  the  ears,  on  the  neck,  and  at  the  root  of  the  tail,  from  which 
locations  it  may  gradually  extend.  The  animals  give  off  a  slightly 
rancid  or  foetid  odor  and  are  slightly  itchy  in  the  early  stages.  There 
may  be  a  bran-like  dandruff  which  increases  in  amount,  later  accompanied 
by  desquamation  of  the  external  epithelium.  The  hair  feels  oily  and 
unhealthy,  imparting  to  the  hand  a  peculiar,  foetid,  unpleasant  odor, 
characteristic  of  this  disease.  The  hair  gradually  falls  out,  and  the 
animal  becomes  bald.  The  treatment  consists  in  bathing  with  strong 
sulphur  soap,  or  soaps  containing  benzoin,  and  the  application  of  sali- 
cylic and  sulphur  ointments. 

Seborrhoea  Oleosa. — This  appears,  as  a  rule,  in  the  parts  having  the 
most  hair,  yet  it  may  also  be  observed  in  the  crural  surface  and  folds. 
It  frec{uently  develops  after  distemper  and  is  sometimes  observed  as  a 
result  of  the  irritation  caused  by  acari.  The  skin  feels  as  if  it  were 
oiled,  and  leaves  the  hand  oily  after  having  stroked  the  animal.  Want 
of  cleanliness  may  occasionally  produce  a  modification  of  this  condition. 

Seborrhoea  praeputi  has  been  described  by  Schindelka  as  appear- 
ing in  dogs  with  very  narrow  contracted  foreskins,  and  has  no  similarity 
or  connection  with  phimosis.  The  preputial  orifice  continually  dis- 
charges a  foetid,  oily-like  fluid,  greenish  in  color,  and  has  much  more 
consistency  than  the  discharge  in  blenorrhcea  of  the  prepuce.  The 
treatment  consists  in  cleansing  of  the  penis  with  an  antiseptic  soap  and 
followed  by  dusting  the  affected  parts  with  dermatol  powder.  If  phi- 
mosis is  present,  the  opening  must  be  enlarged  by  an  incision. 

Pemphigus. — This  appears  in  man  as  a  result  of  a  number  of  diseases, 
and  is  indicated  by  the  appearance  of  a  series  of  vesicles  which  reappear 
from  time  to  time  and  are  apt  to  become  chronic.  In  one  case  observed 
by  Frohner,  a  male  poodle  dog  not  yet  a  year  old  gradually  lost  flesh 
and  became  ansemic.  His  back  and  both  sides  of  the  body  up  to  the 
scapula,  as  well  as  the  upper  part  of  the  legs,  were  denuded  of  hair,  and 
certain  raw  spots  on  the  skin  about  2  mm.  deep,  varying  in  size.  They 
w'ere  light  rose-red  on  the  border,  shiny  red  in  the  centre,  smooth,  glossy 
and  slightly  moist  on  the  surface.  On  the  neck  and  upper  sections  of  the 
anterior  limbs  were  a  number  of  vesicles  the  size  of  a  hazelnut  covered 
with  dirty  brownish-green  crusts.  These  vesicles  gave  out,  when 
pressed,  a  yellowish-white  pus.  The  head,  tail  and  posterior  parts  of 
the  legs  were  free  from  vesicles  or  spots.  The  appetite  was  very  good, 
but  the  animal  grew  weaker  and  weaker,  and  finally  was  destroyed. 

Impetigo. — This  is  a  condition  understood  as  an  eruption  of  pus 
vesicles.  It  is  noticed  frequently  in  distemper,  and  has  been  observed 
in  old  bitches  in  an  advanced  state  of  gestation.  Some  of  them  are  also 
afflicted  with  endometritis. 


CUTAXEOUS  AFFECTIONS  OF  PARASITIC  ORIGIN  461 

On  the  external  portions  of  the  anal  organs,  on  the  skin  of  the 
internal  surface  of  the  legs,  and  the  mammary  glands  were  a  number 
of  pustules  the  size  of  hemp-seed,  filled  with  thick  yellowish  pus  Avhich 
dried,  leaving  a  brown  scab,  followed  by  a  gradual  succession  of  new 
pustules  at  the  periphery  of  the  affected  regions.  There  was  also  more  or 
less  general  disturbance  and  fever.  These  cases,  as  a  rule,  make  a  favor- 
able termination. 

Canina  Bubo. — Frohner  describes  a  purulent  follicular  inflammation 
of  the  lips,  with  lymphangitis  and  lymphadenitis  on  the  head.  This 
he  observed  in  young  dogs.  There  was  swelling  of  the  skin  on  the  face; 
the  lips  became  covered  with  bluish  elevations  which  upon  pressure 
yielded  a  bloody  purulent  fluid. 

The  Ij'mphatic  glands  of  the  larynx  and  the  region  of  the  larynx 
and  the  parotids  became  tumefied,  swelling  to  the  size  of  a  pigeon's  egg. 
One  dog  died  of  pyemia.  Frick  has  seen  a  similar  disease  in  an  old  dog, 
which  he  does  not  think  was  a  specific  condition,  but  due  to  an  extensive 
eruption  of  acne  pustules. 

Noma. — Moeller  compares  this  with  the  noma  (water  cancer)  of 
children.  It  is  a  spontaneous  gangrenous  formation  of  the  jaw,  which 
is  extremely  rare  in  the  dog.  The  affection  is  situated  in  the  corner  of 
the  jaw.  The  gangrenous  condition  developed  very  rapidly,  reaching 
the  size  of  a  dollar  in  a  very  few  days.  The  skin  is  grayish-brown  in 
color,  exfoliates  and  can  easily  be  lifted  from  the  healthy  tissue.  The 
submaxillary  lymphatic  glands  were  tumefied;  there  was  also  fever  and 
salivation.  The  condition  finally  healed,  but  only  after  the  greater 
portion  of  the  jaw  had  been  lost,  the  wound  healing  from  the  periphery. 
The  treatment  consisted  in  the  application  of  a  thermo-cautery,  followed 
by  corrosive  sublimate  solutions,  1  to  3000,  and  the  animal  was  fed  by 
means  of  liquid  nourishment,  being  unable,  on  account  of  the  jaw,  to  pick 
up  the  food  and  chew  it. 

Cutaneous  Affections  Which  are  Caused  by  Animal  Parasites. 

The  changes  produced  in  the  skin  from  disease  caused  by  animal 
parasites  are  divided  into  two  conditions — primary  and  secondary. 

The  primary  appears  as  a  superficial  inflammatory  process,  produced 
directly  by  irritations  of  the  parasites  upon  the  skin,  and  this  condition 
depends  to  a  large  extent  upon  the  amount  of  irritation  and  the  depth 
that  the  parasites  have  penetrated  in  the  skin. 

The  secondary  symptoms  are  the  result  of  this  penetration  into  the 
cutis,  causing  more  or  less  itching  and  irritation,  and,  as  a  rule,  scratching 
and  rubbing  on  the  part  of  the  animal,  producing  heat,  redness,  papules, 
vesicles,  pustules,  hemorrhages,  or  excoriations.     These  irritated  spots 


4G2  DISEASES  OF  THE  SKIN 

may  not  be  restricted  entirely  to  the  affected  region  in  which  the  parasites 
are  located,  but  may  spread  to  other  localities.     This  form,  which  is 

nothing  more  or  less  than  eczema,  pos- 
sesses two  peculiarities  which  may  distin- 
guish it  at  once  from  the  common  form 
of  eczema  which  is  not  produced  by  a 
parasite : 

1.  It    invariably    appears    in  single, 

isolated   eruptive   spots,  and    it    is    only 

after   the   disease   has   been    present    for 

some  time,  or  where  there   is  extensive 

Fig.  162.— Head  of  dog  flea  (Puiex       irritation,  that  we  may  find  the  surface 

canis).    (Megmn.)  connected  together. 

2.  "We  see  the  ajipearance  of  these  eczematous  eruptions  in  certain 

locations  which  are  especially  preferred  by  the  parasites,  and  showing 

their  greatest  development  of  the  eruption  in  those  regions,  even  when 

the  whole  body  is  affected. 

A  microscopical  examination  of  the  scales  of  the  skin  will  furnish 
definite  information  as  to  the  character  of  the  cause  of  the  eruption. 
We  distinguish  two  groups  of  cutaneous  parasites:  First,  those  which 
live  upon  the  external  surface  of  the  skin,  and,  second,  those  which  enter 
the  tissues  of  the  membranes,  penetrating  deeply  into  the  tissues.  In 
the  first  group  we  have  the  following: 

Ceratopsyllus  Canis,  Pulex  Canis,  the  Dog  Flea. 

The  true  dog  flea,  as  well  as  the  human  flea  (pulex  irritans),  is 
found  in  the  dog.  The  former  is  distinguished  from  the  latter  b}^  its 
size,  by  the  different  length  of  its  tentacles,  and  by  the  presence  of  a 
number  of  sharp  hairs  arranged  in  a  comb-like  layer  along  the  side  of 
the  head  (Fig.  1(32).  Coarse  breeds  of  dogs  are  not  particularly  affected 
by  the  bites  of  fleas,  but  pet  clogs  and  delicately  bred  animals  scratch 
and  rub  to  such  an  extent  as  to  cause  irritated  splotches  and  redness 
over  the  entire  body,  and  lead  the  owner  to  believe  that  the  animal  is 
affected  with  mange.  The  skin  is  also  filled  with  the  small  brownish- 
black  excrement  of  the  flea.  If  the  fleas  are  removed  from  the  skin  by  a 
bath  or  in  some  other  manner,  we  may  relieve  the  itching  and  irritation 
by  the  application  of  some  soothing  solution. 

Therapeutic  Treatment. — Fleas  are  best  removed  by  means  of 
Persian  insect  powder  (Flores  pyrethri).  This  must  be  moistened  with 
alcohol  and  rubbed  into  the  hair.  The  animal  must  stand  on  a  sheet  of 
paper  while  this  is  being  done,  as  the  flea  is  not  killed,  but  is  only  tem- 
porarily stupefied  by  the  action  of  the  drug,  and  falls  on  the  paper.     The 


CUTANEOUS  AFFECTIONS  OF  PARASITIC  ORIGIN  463 

paper  with  its  contents  must  be  burned.  Another  method  is  to  take  the 
dog  out  in  a  fiekl  away  from  the  kennel  and  rub  him  thoroughly  with 
spirits  of  camphor,  and  the  fleas  fall  on  the  ground  and  soon  die.  The 
placing  of  cedar  shavings,  walnut  leaves  or  pine  shavings,  in  dogs'  ken- 
nels tends  to  keep  away  the  parasites.  Parsely  seed  and  absinthe  powder 
are  also  useful.  In  fine  pet  animals  the  daily  rubbing  into  the  skin  of 
spirits  of  camphor  drives  away  the  fleas  and  the  camphor  left  on  the  skin 
after  the  alcohol  evaporates  has  a  tendency  to  keep  the  fleas  away. 
Rubbing  with  laurel  oil,  or  a  mild  solution  of  creolin  (2  per  cent.)  may 
be  tried,  the  latter,  how^ever,  being  apt  to  roughen  the  hair  in  soft-haired 
dogs.  The  blankets  or  cushions  where  the  dog  sleeps  should  occasion- 
ally be  subjected  to  heat.  The  best  plan  is  to  put  the  blankets  or 
cushions  in  an  oven  that  is  moderately  warm,  and  leave  them  there  for 
ten  or  fifteen  minutes.  This  destroys  the  parasites  and  kills  the  germ 
in  the  eggs.  In  a  kennel  the  washing  of  the  floor  wdth  corrosive  sublimate 
solution  1  to  300,  or  creolin  1  to  100,  and  allowing  the  solution  to  go 
down  between  the  cracks  where  the  eggs  lie  is  particularly  useful. 

Pulex  Penetrans,  Sarcopsylla  Penetrans  (Sand  Flea). — This  is  some- 
what smaller  than  the  dog  flea  and  is  found  in  America  and  since  1872 
in  certain  parts  of  Africa.  It  lives  in  sand  and  on  weeds.  It  lives  on 
man  as  well  as  the  dog,  and  while  the  mature  male  and  virgin  female 
cause  little  or  no  inconvenience,  the  pregnant  female  burrows  into  the 
skin,  burrowing  until  the  head  is  in  the  skin,  leaving  the  body  protruding. 
In  a  few  days  the  body,  in  consequence  of  the  development  of  numerous 
eggs,  grows  to  an  enormous  size  in  propor- 
tion to  its  normal  size,  sometimes  getting  as 
large  as  a  pea  (Fig.  163).  It  causes  more  or 
less  itching  while  it  is  in  the  skin,  and  if  the 
dog  should  gnaw  and  kill  the  insect,  it  is  apt 
to  act  as  an  irritant,  causing  suppuration  and 
in  some  cases  necrosis  of  the  skin.  Great  care 
must  l)e  used  in  removing  these  ticks,  as  care- 
less removal,  as  has  iust  been  said,  causes  Fig.  les.— Female  puiex  pene- 
trans greatly  enlarged, 
irritation    and    abscess.     Saturate    a    pad    of 

cotton  with  chloroform  or  ether  and  lay  it  over  the  parasite  which  im- 
mediately liberates  its  holding  hooks  in  the  skin  and  falls  off. 

Haematopinus  Piliferus  (Dog  Louse)   and  Trichodectes  Latus. 

{Dog  Parasites.) 

Description  of  Haematopinus  Piliferus. — This  parasite  is  distinguished 
by  an  egg-shaped  head  fitted  with  fine,  short  hairs  and  fleshy  sheath-trunk 
with  hooks  at  the  edge.     This  when  lifted  shows  a  sucking  tube  and  two 


4G4 


DISEASES  OF  THE  SKIN 


movable  knife-shaped  stilettos.  The  thorax  is  wrinkled  and  possesses 
three  pairs  of  scissor-like  claws.  The  posterior  portion  of  the  body  is 
large  and  possesses  nine  rudimentary  legs.  The  length  of  the  body  is 
about  2  mm.  (see  Fig.  1()4  ti). 

Description  of  the  Trichodectes. — In  this  parasite  the  head  is  l)roa(l, 
quarter-shaped,  with  three  manacle  feelers  and  a  tooth-shaped  mouth. 
The  thorax  is  contracted,  the  posterior  part  of  the  body  has  nine  distinct 
members,  and  the  length  of  the  body  is  from  1  to  2  mm,  (see  Fig. 
164  b). 

The  former  parasites  are  the  most  disagreeable,  as  they  suck  the 
blood  from  the  body,  live  particularly  on  those  parts  of  the  skin  where 
the  hair  is  thick  and  which  are  not  exposed  to  the  cold,  such  as  the  neck, 
flanks,  and  around  the  base  of  the  tail.  The  trichodectes  feed,  as  a  rule, 
upon  the  hair  and  epidermis,  and  are  found  particularly  on  the  head  and 


Fig.   164a.  Fig.   164b. 

Hsematopinus  piliferus.  Trichodectes  latus. 

The  accompanying  small  lines  give  the  natural  size  of  the  parasite. 

neck.  Both  skin  parasites  produce  intense  irritation  and  rubbing, 
causing  inflammatory  efflorescences  which  look  very  much  like  squamous 
eczema,  with  partial  loss  of  hair  and  formation  of  scabs.  The  diagnosis 
is  usually  easy,  as  we  can  see  the  parasites  and  their  eggs  by  separating 
the  hair. 

Therapeutic  Treatment. — This  consists  of  destroying  the  parasites 
and  their  eggs.  For  that  purpose  it  is  often  requisite  to  clip  the  animals. 
The  safest  and  least  harmful  agents  are  decoctions  of  tobacco  (5  to  10 
per  cent.),  solutions  of  creolin  (3  to  6  per  cent.),  petroleum  (crude,  or 
mixed  with  benzine,  lysol  or  sapo-cresol) ,  and  in  small  dogs  anise-seed 
oil  (1  to  10  per  cent,  of  olive  oil).  Mercurial  ointment  may  be  rubbed  in 
the  neck  around  the  collar,  but  we  must  not  apply  more  than  a  piece  the 
size  of  a  bean,  as  it  is  apt  to  cause  salivation.  Washing  with  corrosive 
sublimate  solution  has  been  tried,  but  it  must  be  carefully  done,  as  the 
same  precaution  has  to  be  taken  as  with  mercury  ointment,  the  animal 
not  being  allowed  to  lick  the  body,  as  it  is  very  apt  to  produce  mercurial 


CUTANEOUS    DISEASES  DUE   TO  ANIMAL  PARASITES  465 

symptoms    of    salivation.     Insect    powder    (pyrethrimi),    mixed    with 
alcohol,  can  also  be  rubbed  into  the  body. 

Ixodes  Ricinus. — This  parasite,  which  is  about  2  mm.  in  length,  and 
sometimes  when  full  grown  almost  3  mm.,  looks  very  much  like  an 
acarus.  It  penetrates  into  the  skin  and  sucks 
the  blood,  and  is  generally  seen  in  setters  or 
pointers,  and  dogs  when  working  through  the 
woods  and  underbrush  become  filled  with  them. 
Turpentine  and  petroleum  will  destroy  them  in- 
stantly, or,  better  still,  a  small  quantity  of  chloro- 
form or  ether  sprayed  on  the  skin  makes  them 
loosen  their  hold  immediately.  They  should  never 
be  forcibly  pulled  away  from  the  skin  as  they  leave 

.  .  .      .  Fig.  165. — Ixodes  ncinus. 

the  mandibles  m  the  skm  and  cause  great  irrita-    The  accompanying  line  is 
tion  and  frequently  an  abscess.  ^^'^  natural    size   of   the 

Leptus  Autumnalis. — This  is  what  is  known 
as  a  "harvest  bug"  or  acarus.  It  is  about  4  mm.  in  length, 
and  is  the  red  larva  of  thrombidium  holosericeum.  While  human 
beings  are  c{uite  frequently  affected  with  this  parasite,  it  is  only 
rarely  found  in  the  dog.  Pustular  inflammations  of  the  skin  of  the 
dog  are  sometimes  produced  by  this  parasite.  The  rash  was  very 
prominent  on  the  abdomen  and  the  inner  fascia  of  the  legs,  and  was 
healed  quickly  by  an  application  of  carbolic  acid  and  glycerine,  or 
carbolated  cosmoline. 

Dermatophagus  Canis. — This  is  very  rarely  found  in  the  dog,  and  is 
a  parasite  which  affects  the  ear,  producing  otitis  externa.  For  further 
details  refer  to  Parasitic  Otitis  (page  439). 

CUTANEOUS  DISEASES  DUE  TO  ANIMAL  PARASITES. 

Sarcoptes  Scabiei. 

{Sarcoptic  Manyc;  Scabies  Sarcoptica.) 

Sarcoptic  mange  (common  mange,  scab)  is  a  disease  of  the  skin 
which  is  very  common,  particularly  where  a  large  number  of  animals 
are  together.  It  is  accompanied  by  violent  itching,  and  is  due  to  the 
presence  in  the  integument  of  the  sarcoptes  scabiei  squamiferis. 

Description  of  Sarcoptes  Scabiei. — This  parasite  is  about  0.2  to  0.3  mm. 
broad  and  from  0.2  to  0.5  mm.  long.  It  has  a  rounded,  turtle-like  shape 
and  a  horseshoe-shaped  head,  with  well-developed  club-shaped  scissor- 
like  jaws.  It  has  short  rudimentary  feet,  and  tulip-shaped  suction  cups 
which  are  attached  to  the  first,  second,  and  fourth  pairs  of  feet  in  the 
male,  while  in  the  female  they  are  found  in  the  first  and  second  pairs  only. 
In  the  back  we  see  six  elongated  acorn-shaped  scales  or  thorns,  and  four 
30 


40(3 


DISEASES  OF  THE  SKIN 


rows  of  lance-shaped  scales  on  the  upper  surface  of  the  back.  The  skin 
.shows  transverse  folds  and  we  find  four  elongated  hairs  on  the  posterior 
end  of  the  body  (Fig.  166). 

The  male  acari  and  the  young  parasites  generally  inhabit  cavities 
in  the  skin  which  they  have  made  for  themselves 
(Fig.  167).  These  cavities  are  connected  extern- 
ally by  short  ducts,  the  entrances  of  which  may  be 
marked  by  small  vesicles  or  pustules,  while  the  fe- 
male may  move  to  different  parts  of  the  body 
when  sexually  ripe,  burrowing  ducts  through  the 
upper  layers  of  the  epidermis  down  as  far  as  the 
membrana  Malpighii,  which  contains  a  great  deal 
of  fluid.  At  the  end  of  the  duct,  that  is,  the  place 
of  entrance  of  the  acari — w^e  see  the  development 
of  a  small,  somewhat  moist  nodule,  or  a  vesicle, 
which  dries  up  ultimately,  leaving  a  scar.  This 
digging  of  the  parasite  may  produce  more  or  less 
separation  of  the  epidermis.  "We  generally  find  that  the  parasite  has  a 
preference  for  certain  parts  of  the  body,  such  as  the  head,  neck,  abdo- 
men, and  chest,  at  the  root  of  the  tail,  and  the  paws.     It  is  very  hard 


Fig.  166. — Female  sar- 
coptes  of  the  dog,  magni- 
fied 75  times,  giving  the 
a'jdominal  view.  {Siedani- 
grotzky.) 


Fig.  167. — Female  sarcoptes  burrowing  in  the  skin;  also  eggs  and  excrement. 

to  detect  it  with  the  microscope.  The  best  may  is  to  remove  some  of  the 
membrane  with  a  scissors  or  scrape  the  upper  portion  of  the  skin  to  the 
corium.  If  parasites  have  been  present  for  some  time,  a  secondary 
eczema  is  soon  developed,  which  is  produced  by  scratching  and  rubbing, 
also  by  itching  of  the  scabs  and  scales.  This  "  mange  eczema  "  appears  in 
various  forms,  according  to  the  sensitiveness  of  the  skin,  and  is  either 
papular,  vesicular,  or  pustular,  and  sooner  or  later  produces  decided 
thickness  of  the  skin  and  leads  to  the  formation  of  a  number  of  folds, 
■wrinkles,  and  ulcerated  points  between  the  clefts  of  the  wrinkles.  There 
is  always  a  certain  characteristic  appearance  about  these  affected  local- 
ities which  makes  it  easy  to  distinguish  between  the  parasitic  and  simple 


CUTANEOUS  DISEASES  DUE  TO  AXIMAL  PARASITES  4G7 

eczema.  The  surface  finally  becomes  confluent,  forming  large  eczema- 
tous  areas.  It  is  very  improbable  that  a  mistake  will  be  made  in  diag- 
nosis, except  in  the  early  stages,  when  there  is  only  a  very  small  spot 
affected,  because  the  parasitic  eczema  produces  rapid  characteristic 
changes,  accompanied  by  scratching,  twitching,  rubbing,  and  licking, 
which  are  very  much  aggravated  as  soon  as  the  animal  is  placed  near  any 
warm  object,  for  instance  in  the  neighborhood  of  a  stove  or  if  covered  up 
with  a  blanket,  and  also  the  evident  pleasure  which  the  animal  gets  if 
the  affected  part  is  rubbed  or  scratched,  and  finally,  if  the  animal  is 
kept  with  other  clogs,  the  disease  is  carried  to  them  and  developed  very 
quickly. 

In  making  a  differential  diagnosis  between  sarcoptic  and  follicular 
mange  we  may  frecjuently  find  that  in  follicular  mange  the  eruption 
may  be  very  similar  to  sarcoptic,  but  the  itching  is  very  slight  in  follicular 
mange;  in  fact,  in  some  cases  of  follicular  mange  scratching  or  rubbing 
an  affected  animal  very  frequently  causes  the  animal  pain,  and  there  is 
rarely  any  pus  in  the  pustules  of  sarcoptic  mange,  whereas  in  follicular 
mange  the  pustules  contain  pus  and  when  squeezexl  out  and  examined 
under  the  microscope,  the  matter  is  filled  with  acari.  Of  course  it  is  not 
impossible  to  have  both  sarcoptic  and  follicular  mange  present  in  the 
same  animal. 

The  prognosis  is  not  unfavorable,  as  vigorous  treatment  usually 
cures  an  animal  in  a  short  time,  provided  the  disease  has  not  covered 
the  whole  body.  If  it  has  extended  over  the  body  in  young  animals,  it 
may  cause  great  emaciation,  and  in  some  cases  great  alteration  of  the 
skin,  and  if  the  animal  is  greatly  run  down,  it  is  a  question  whether  they 
can  stand  energetic  treatment.  When  the  parasites  are  destroyed, 
frequently  we  find  an  eczema  follows  that  is  very  obstinate  and  it  takes 
some  time  before  the  skin  returns  to   its  normal  condition. 

Therapeutic  Treatment. — In  order  to  produce  good  results  in  mange 
we  must  kill  or  remove  the  parasites,  their  larva  and  eggs,  as  the  itching 
and  scratching  ceases  as  soon  as  they  are  destroyed,  and  naturally  the 
artificial  eczema  also  disappears  rapidly.  A  large  number  of  anti-para- 
sitic agents  are  used — creolin,  carbolic  acid,  coal-tar,  anthracol  perugen, 
ichthyol,  sulphur,  petro-sulphol,  septoform,  formaline.  The  prepara- 
tions generally  used  are  creosote,  wood-tar,  creolin,  sulphol-cresol,  styrax, 
and  epicarin,  lysol,  salicylic  acid,  and  Peruvian  balsam.  They  are  all 
useful,  and  may  be  applied  according  to  the  following  directions: 

It  is  always  necessary  to  make  a  general  application  of  the  agent, 
even  in  such  cases  where  the  disease  seems  to  be  restricted  to  one  region 
of  the  body.  The  dog  must  have  the  hair  shaved  off,  if  necessary;  be 
covered  all  over  with  a  layer  of  soft  soap  or  with  Hebra's  alcoholic 
potash  soap,  which  is  to  be  shampooed  into  the  skin  with  the  hands  or  a 


408  DISEASES  OF  THE  SKIN 

stiff  brush,  and  cleansed  thoroughly  in  clear  tepid  water.  The  agent 
which  is  to  be  used  is  then  applied  with  the  hand  or  with  a  brush,  covering 
only  one-third  of  the  body  at  a  time,  repeating  the  operation  in  two  or 
three  days.  If  the  whole  body  is  affected  in  spots,  cover  the  whole  body. 
A  good  general  plan  is  to  give  one  thorough  application  to  the  body,  three 
days  later  another,  then  three  days  after  that  a  third  application,  and 
three  days  after  that  the  application  may  be  removed  by  soft  soap  and 
water,  then  if  the  animal  is  at  all  suspicious  repeat  the  whole  cycle  a 
second  time.     The  best  ointments  for  mange  are: 

1.  Picis  liquid  a,  sapo  potassii  viridis,  spiritus  vini  rect.,  equal  parts, 
q.  s.     Ft.  linimentum. 

2.  Creolin,  sapo  potassii  viridis,  of  each  1  part;  spiritus  vini  rect., 
10  parts. 

3.  Creosoti,  1  part;  picis  liquida,  sapo  viridis, spiritus  vini  rect., aqua, 
of  each  7  parts. 

4.  Creolini  (lysol  bacillol,  liq.  cresolis  saponat) ;  petrolatum  12. 

5.  Two  to  5  per  cent,  solution  of  creosote  or  carbolic  acid  in  olive  oil. 

6.  Peruvian  balsam  1  part,  spiritus  vini  rect.  3  parts. 

7.  Peruvian  balsam  1,  sapo  viridis  1  part,  spiritus  vini  rect.  5. 

8.  Styrax  2,  alcohol  1,  olive  oil  2. 

9.  Sulphur  sublimed,  pix  Carolina  each  3,  creta  preparata  2,  saj^o 
viridis,  adeps,  of  each  6. 

10.  Epicarin,  oleum  ricini,  ether  sulph.  1,  alcohol  9. 

The  first  five  agents  which  are  mentioned  are  very  energetic,  but 
more  or  less  dangerous,  so  it  is  advisable  to  use  them  in  healthy  or  not 
too  young  or  delicate  animals,  and  if  the  animal  is  greatly  depressed,  no 
appetite,  and  has  either  slight  convulsions  or  dark-colored  urine,  or  both, 
the  preparation  must  be  washed  off  immediately,  and  at  the  same  time 
administer  small  quantities  of  sulphate  of  sodium  in  their  drinking- 
water  in  order  to  prevent  carbolic  poisoning.  Peruvian  balsam  is  harm- 
less and  very  useful,  but,  unfortunately,  it  is  expensive,  and  is  only 
adapted  to  very  fine  pet  dogs.  At  the  same  time  if  it  can  be  procured 
and  it  is  not  adulterated,  it  is  by  far  the  cheapest  in  the  end,  as  it  is  not 
dangerous  and  it  can  be  applied  liberally.  The  coal-tar  products  are 
always  more  of  less  dangerous  on  account  of  the  ready  absorption  of 
such  preparations,  Styrax  renders  the  hair  very  sticky.  The  solution 
of  epicarin  is  used  for  very  delicate  house  dogs  in  the  early  stages  of 
the  disease;  the  hair  need  not  be  shaved  off  when  using  this  combination, 
and  should  be  rubl)ed  in  thoroughly  every  third  day.  It  is  apt  to  sting 
and  smart  the  animal  and  they  may  become  greatly  excited.  During 
the  treatment  it  is  well  to  give  strong  nourishing  food,  and  as  the  animals 
are  either  shaved  or  the  body  covered  with  an  oily  preparation,  to  keep 
them  in  warm  houses  or  kennels. 


ACARUS  DEM  ODE  X  FOLLICULORUM 


4G9 


Prevention  Methods. — The  owner  of  the  dog  must  have  his  attention 
called  to  the  fact  that  the  sarcoptes  are  highly  contagious,  and  may  pro- 
duce similar  complications  in  other  dogs  and  in  man;  and  while  this  in 
man  may  be  of  a  very  mild  character,  it  has  been  observed  in  the  acute 
form  in  several  cases. 

The  contact  of  many  dogs  with  healthy  animals  must  be  prevented 
and  covers,  blankets,  bedding,  etc.,  which  have  been  used  by  the  affected 
animals  must  be  subjected  to  a  thorough  cleansing  by  washing  with  hot 
solutions  of  soda  and  a  high  degree  of  heat.  The  straw,  of  course,  must 
be  burned. 


FOLLICULAR  MANGE.  ACARUS  MANGE.  ACARIASIS. 
Acarus  Demodex  Folliculorum. 

Follicular  mange  is  a  very  serious  affection  due  to  the  presence  of 
the  acarus  demodex  folliculorum  in  the  skin  and  particularly  the  hair- 


1:100. 


Fig.   168.  Fig.    169.  Fig.   170. 

Fig. 168. — Development  of  the  acarus  folliculorum:  Egg;  six-legged  larva;  eight-legged  larva,  and 
developed  larva. 

Fig.  169. — Acarus  folliculorum  greatly  magnified. 

Fig.  170. — Hair-follicle  invaded  by   demodectes  folliculorum. 

follicles.     It  differs  from  sarcoptic  mange  in  that  it  is  rarely  itchy,  and 
if  so,  only  very  slightly. 

Description   of   the   Acarus. — This   parasite   is   about   0.3   mm.    in 
length  and  about  0.045  mm.  in  breadth,  elongated,  lanceolate,  with  a 


470  DISEASES  OF  THE  SKIN 

lyre  or  horseshoe  head,  provided  with  a  broad,  scissors-like  masticatory 
apparatus,  a  mobile  anterior  trunk,  arul  three  articulated  tentacles 
(Fig.  IGy),  It  has  an  oblong  or  worm-shaped,  wrinkled  abdomen,  with 
eight  triple-jointed,  clawy,  thick,  short  feet  attached  to  the  thorax. 
The  elongated  oval  larvae  have  only  six  legs  (Fig.  168).  The  eggs  are 
spindle-shaped,  and  the  larvae  escape  from  the  eggs,  almost  fully  devel- 
oped. The  exception  is  that  the  newly  born  larvse  have  only  six  feet 
(Fig.  168).  _ 

These  parasites  are  found  in  the  hair-follicles  and  sebaceous  glands, 
their  head  toward  the  bottom  of  the  sac,  and  the  caudal  end  toward  the 
external  opening  (Fig.  170).  Their  number  may  be  large  in  a  sebaceous 
gland,  even  as  many  as  200  have  been  found  there.  They  generally  average 
from  twenty  to  thirty.  The  larvse  and  eggs  lie  beside  the  parasite.  The 
irritation  of  the  parasite,  causes  the  follicles  and  sebaceous  glands  to  become 
dilated  and  the  subsequent  atrophy  of  the  hair  papilla  causes  falling  out  and 
permanent  loss  of  hair  and  where  there  is  a  great  number  of  parasites 
present,  pus  is  produced  and  a  purulent  inflammation  of  the  perifollicular 
and  periglandular  tissue  ensues,  with  the  formation  of  pustules.  The  re- 
lapses, after  the  disease  appears  cured,  may  be  due  to  temporarily  encysted 
units.  It  may  be  that  these  parasites  may  have  been  in  some  inac- 
cessible place,  such  as  the  eye,  ear,  or  prepuce.  In  very  severe  cases 
with  numerous  pustules  of  the  sebaceous  glands,  death  may  occur 
from  general  septic  infection.  The  secbaeous  glands  are  also  de- 
stroyed, causing  aeneous  pustules.  The  demodex  acne  shows  itself 
in  certain  preferred  parts  of  the  body,  especially  the  head,  throat, 
neck,  and  paws,  but  it  may  extend  over  the  entire  body.  It  is  not  very 
easily  transmitted  from  one  animal  to  another,  as  has  been  proven  by  the 
attempts  made  by  Weiss,  Martemucci,  and  others,  who  were  unsuccess- 
ful. The  writer  had  four  dogs,  two  adults  and  two  pups,  and  kept  them 
for  months  with  a  bitch  that  was  badly  affected  with  acari,  but  failed 
to  get  any  signs  of  transmission.  When  the  animals  have  been  experi- 
mentally inoculated  Haubner  reported  a  case  in  which  twenty-four  hours 
after  inoculation  there  were  all  the  marks  of  the  disease  and  the  sac 
contained  eggs  and  larvse.  A  second  inoculation  cured  itself  spontane- 
ously. Other  observers  have  had  similar  experiences.  It  seems  that  to 
propagate  the  disease  the  animal  must  have  a  certain  predisposition,  the 
nature  of  which  has  not  been  satisfactorily  explained.  Young  dogs  when 
exposed  to  infection  seem  to  take  it  more  readily  than  older  dogs,  but 
whether  it  is  congenital  is  a  question.  The  natvu-al  method  of  contagion 
is  the  contact  of  healthy  dogs  with  diseased  ones,  but  there  is  no  doubt 
that  some  individuals  ai-e  immune. 

Clinical  Symptoms  and  Course. — These  are  distinguished  by  a  pustu- 
lar and  sc^uamous  form  of  eruption,  but  both  forms  are  apt  to  be  united 


DERM(JDKCTES    K(JLl,lCUl-ORUM    {.hrmodeUk  mange.) 


ACARUS  DEM  OBEX  FOLLICULORUM  471 

in  the  same  animal.  The  pustular  form  is  the  most  common,  and  may 
be  recognized  by  the  hair  falling  out,  by  hypenemic  and  swollen  skin, 
which  becomes  thickened  and  in  folds,  and  red  from  lack  of  pigment, 
forming  nodules  often  the  size  of  a  millet  seed,  which  change  from 
bluish-red  to  yellow  pustules,  and  finally  the  purulent  bloody  contents 
escape,  and  in  it  and  under  the  membrane  we  find  hundreds  of  acari. 

The  itching,  as  a  rule,  is  never  very  great,  as  in  sarcoptic  mange, 
and  in  some  cases  not  even  present.  When  the  affected  cutaneous 
regions  are  scratched  or  rubbed,  the  patients,  as  a  rule,  resent  it  and  do 
not  derive  the  pleasure  that  scratching  gives  in  sarcoptic  mange.  The 
disease  spreads  very  slowly,  the  eruption  starting  at  the  head  and  between 
the  toes,  and  in  only  very  rare  instances  does  it  cover  the  whole  body 
(see  Plate).  The  parts  that  are  affected  finally  heal,  l)ut  the  skin 
remains  thick,  denuded  of  hair,  marked  in  some  places  by  scars  or  cica- 
trices, and  also  by  cracks  and  wrinkles.  In  some  cases  we  may  have  a 
dark  pigmentation  marked  with  warty  projections.  When  there  is  any 
itching  present  the  appearance  of  the  cutis  may  be  changed  materially 
by  secondary  eczema.  The  appetite  is  very  rarely  afTected,  the  animal 
eating  well,  although  some  cases,  in  spite  of  good  food,  have  shown  the 
animal  to  have  an  impoverished,  unhealthy  look. 

The  squamous  form  is  seen  in  the  neighborhood  of  the  eyes,  the 
In-idge  of  the  nose,  forehead  and  the  anterior  surface  of  the  neck  (Fig.  171) 
and  breast,  but  it  may  show  itself  in  other  parts  of  the  body.  It  is  a 
normal  cutaneous  inflammation  accompanied  by  falling  out  of  the  hair 
and  great  accumulation  of  scabs,  and  isolated  bare  spots  resembling 
alopecia  areata.  The  hair  drops  from  the  afTected  places.  The  skin  is 
only  slightly  reddened,  but  covered  with  thick  scabs.  If  these  places 
are  squeezed,  the  parasites  can  be  pushed  out  of  the  skin  very  rapidly. 
The  easiest  way  to  obtain  the  parasites  is  to  rub  the  blunt  end  of  a  knife, 
previously  clipped  in  oil,  over  the  affected  parts,  and  the  microscope  will 
aid  you  in  distinguishing  this  disease  from  simple  scaly  eczema.  In  any 
suspicious  bald  spots  on  an  animal,  it  is  always  well  to  scrape  off  a  portion 
of  the  affected  part  and  give  it  a  close  examination  under  the  microscope. 
The  pustular  form  seems  to  be  more  frequently  observed  in  the  last  few 
years.  This  form  of  the  disease  appears  as  a  series  of  hard  nodules  in  the 
skin,  ranging  in  size  from  a  millet  seed  to  that  of  a  pea,  and  when  they 
appear  in  numbers  they  are  apt  to  become  confluent  and  merge  into  one 
nodular  mass,  and  the  tissue  in  the  affected  region  assumes  a  reddish- 
blue  color.  On  pressure  of  one  of  these  nodular  masses  there  exudes 
from  it  a  purulent  sanguineous  fluid  which,  when  examined  under  the 
microscope,  is  found  to  contain  numerous  dermodectic  acari.  After  the 
nodules  empty  or  are  evacuated,  the  skin  becomes  covered  with  scales 
or  crusts.     The  animal  is  not  itchy  in  this  condition,  or  if  so  it  is  in  very 


472 


DISEASES  OF  THE  SKIN 


slight  degree,  and  not  in  any  sense  at  all  like  the  intense  itchiness  of 
sarcoptic  mange;  generally  the  animals  when  scratched  or  rubbed  in  the 
affected  region  evince  pain  and  endeavor  to  get  away.  In  case  the  animal 
should  show  a  certain  amount  of  itchiness  it  is  not  at  all  impossible  that 
the  animal  may  have  sarcoptic  mange  as  well  as  dermodectic  even  if 
all  the  symptoms  of  follicular  disease  are  present.  The  pustular  form 
of  the  disease  seems  to  attack  the  head  and  neck  more  frequently  than  any 
other  part  of  the  body;  that  is,  it  commences  there,  as  a  rule,  and  grad- 


Fig.  171. — Head  of  dog  affected  with  demodectes  foUiculorum. 

ually  spreads  from  that  point  to  other  parts  of  the  body.  The  disease 
goes  through  the  phenomena  of  developing  the  nodules,  accompanied  by 
acute  local  inflammation  of  the  skin.  This  is  followed  by  purulent 
inflammation  of  the  nodules  and  the  discharge  of  a  serous  purulent  or 
sanguineous  fluid.  The  abscess  gradually  dries  up  and  the  skin  as  a 
consequence  of  the  local  thickening  of  the  cuticle  becomes  traversed  by 
grooves  and  fissures  and  is  covered  with  crusts  and  scales,  assuming  a 
gray-blue  color  in  some  places  and  copper-red  in  others  (see  Plate),  and 
looks  like  elephant  hide.  As  the  nodules  dry,  there  is  apt  to  be  a 
secondary  eczema,  causing  the  animal  to  scratch  more  or  less. 


ACARUS  DEMODEX  FOLLICULORUM  473 

The  prognosis  is  generally  unfavorable,  as  it  is  almost  impossible 
to  reach  the  parasites,  and  it  is  necessary  to  continue  vigorous  treatment 
for  months,  and  then,  when  apparently  the  animal  seems  to  have  gotten 
entirely  well  and  remains  so  for  a  certain  interval,  invariably  it  suddenly 
bursts  out  and  the  disease  appears  with  increased  violence.  The  cases 
which  are  successfully  treated  are  those  that  are  limited  to  a  very  much 
restricted  area,  but  it  must  be  borne  in  mind  that  every  recovered  case 
must  be  closely  watched  for  months  after  the  active  symptoms  disappear. 
This  is  especially  the  case  with  the  squamous  form,  which  is  always 
considered  the  worst  form  of  follicular  parasitic  mange. 

Therapeutics. — The  hair  must  be  shaved  off  in  the  diseased  portion 
and  to  include  a  good  portion  of  the  surrounding  tissues,  or  if  the  animal 
is  affected  generally,  the  whole  body  should  be  clipped.  This  can  be 
done  by  means  of  a  scissors,  clippers,  or  even  lathered  and  shaved  with 
a  razor,  and  the  hair  removed  should  be  burned  and  the  instruments 
thoroughly  disinfected.  The  animal  is  then  bathed  in  warm  water  and 
soft  soap,  to  which  is  added  in  the  proportion  of  1  to  10,  creolin,  pix 
liquida,  or  styrax.  Sulphuretted  baths  are  then  to  be  repeated  twice  a 
week.  Fill  a  large  tub  or  barrel  and  add  from  50.0  to  200.0  of  sulphuret 
of  potash,  and  to  prevent  the  too  free  liberation  of  sulphuretted  hydrogen 
5.0  of  sulphuric  acid  should  be  added.  The  toxic  properties  of  the 
hydrogen  gas  makes  it  necessary  to  keep  the  tub  in  an  open  shed  or  out 
in  the  air. 

(a)  Treatment  of  the  Pustular  Form. — When  pustules  are  present 
they  must  be  squeezed  and  emptied  every  day.  In  some  instances  it  is 
necessary  to  open  the  hard  nodules  by  means  of  a  sharp  scalpel,  and  at  the 
same  time  apply  the  antiparasitic  agents  already  mentioned  with  a  brush 
twice  daily.  The  animals,  as  a  rule,  show  great  pain  and  object  to  it, 
but  to  obtain  any  good  results  this  must  be  followed  up  patiently.  Any 
of  the  solutions  may  be  used,  as  one  is  as  good  as  another,  but  we  must 
remember  that  where  we  have  an  opening  directly  into  the  deep  portions 
of  the  skin  that  reabsorption  of  poisons  through  the  membrane  is  much 
easier,  consequently  it  is  better  to  select  a  non-poisonous  remedy,  such 
as  Peruvian  balsam  or  warm  preparations  of  salicylic  acid  (1  part  of 
salicylic  acid  to  40  parts  of  olive  oil).  Both  agents  may  be  replaced  by 
styrax  (in  oil  solution).  Solutions  such  as  tincture  of  iodine,  Lugol's 
.solution,  corrosive  sublimate  are  all  more  or  less  dangerous  and  never 
can  be  used  with  the  same  freedom  as  the  balsam. 

(6)  Treatment  of  the  Squamous  Form. — In  this  condition  we  must 
first  try  to  reach  the  parasites,  and  this  we  do  by  systematic  rubbing 
with  acid  ointments  or  strong  concentrated  salicylic  ointments  (1  to  5), 
and  also  with  soft  soap  or  lye.  When  we  have  removed  the  scabs  and 
scales  with  this  form  of  treatment  we  must  apply  the  same  treatment 


474  DISEASES  OF  THE  SKLY 

as  prescribed  in  the  pustular  form.  The  prophylactic  measures  must 
be  the  same  as  in  sarcoptic  mange.  No  transmission  of  this  disease  has 
ever  been  observed  in  man.  The  following  are  some  of  the  remedies 
with  their  formulas:  Cerate  of  cantharides  and  lard,  1  to  G;  tincture  of 
iodine  and  chloroform;  oil  of  turpentine  and  chloroform;  styrax,  oleum 
petrse  and  alcohol;  endermol,  1  per  cent,  solution;  zymoidin  in  the  form 
of  ointment;  naphthol  10.0,  sulphur  50.0,  green  soap  and  lard;  ung. 
sulphur  comp.  with  creolin  baths  or  decoction  of  tobacco;  silver  nitrate, 
5  per  cent,  solution;  ichthargen,  10  per  cent,  solution  alternated  with 
iodine  10  per  cent.,  and  tar  25  per  cent.,  each  well  rubbed  in;  styrax 
salve  and  bathing  with  liver  of  sulphur;  formaline  in  2  per  cent,  solution; 
dermaform,  oleoformaldehyde;  creolin  and  alcohol,  equal  parts;  licjuor 
creositi  saponis;  creosote  diluted  with  alcohol  or  sweet  oil;  creolin,  balsam 
of  Peru  and  alcohol,  equal  parts;  ichthyol,  soft  soap  and  alcohol,  equal 
parts;  oil  of  juniper;  scraping  the  affected  parts  wath  a  blunt  knife  and 
applying  balsam  of  Peru;  xeroform;  endermal  injections  of  iodine,  or 
2  per  cent,  solutions  of  carbolic  acid;  superficial  cauterization  of  the  skin 
with  the  thermo-cautery;  carbonate  of  sulphur  as  a  bath  and  then 
frequent  applications  with  the  powder  and  follow^ed  by  an  ointment, 
formaline  3.0,  vaseline  50.0,  oxide  of  zinc  and  almond  powder,  each  24.0. 
Where  the  skin  is  greatly  thickened  carbonate  of  sulphur  should  be  used 
in  conjunction  with  sulphur  or  neutral  soaps. 

And  to  sum  up  the  treatment,  when  you  find  an  animal  that  is 
slightly  affected  with  the  disease,  clean  the  skin  thoroughly  with  a 
strong  soap  and  then  apply  the  balsam  of  Peru  liberally  as  directed  and 
keep  up  the  treatment  for  some  time,  and  if  you  find  an  animal  that  is 
very  badly  affected  then  you  had  better  destroy  him,  as  he  is  not  only 
a  menace  to  every  other  clog  he  comes  in  contact  with,  but  the  chances 
of  a  permanent  cure  are  extremely  slight. 


Skin  Diseases  Caused  By  Worms. 

Rivolta  has  described  having  seen  in  the  neck  of  a  dog  a  herpetical 
eruption  which  he  found  to  be  due  to  the  presence  of  certain  embryos 
which  he  thought  were  the  embryos  of  the  Filaria  inedinenHis.  Seid- 
amgrotzky  also  found  in  a  large  hound  dog,  a  pustulous  eruption  on  the 
external  surface  of  the  shank  of  the  leg  which  was  accompanied  by 
A'iolent  itching  and  in  every  pustule  he  found  from  1  to  3  small  embi-yos 
0.04  to  0.07  mm,  long  and  having  a  peculiar  awl-shaped  caudal  appendix. 
The  embryos  newly  born  and  solitary,  the  females  were  found  in  the 
bedding  of  the  animal.  Schneider  found  a  similar  condition  in  a  pointer, 
but  there  was  little  or  no  itching.     The  case  observed  by  >Scidamgrotzky 


AFFECT lOXS  CAUSED  BY   VEGETABLE  PARASITES  475 

was  cured  spontaneously  in  three  weeks;  in  the  case  described  by  Schnei- 
der it  was  necessary  to  use  a  oU  per  cent,  sohition  of  balsam  of  Peru  in 
alcohol,  to  destroy  the  parasites. 

The  Filaria  immitis  and  Filaria  medinensis  are  found  encysted  in 
the  subcutis.  The  embryos  of  the  former  are  found  in  the  blood  and 
also  in  the  connective  tissues  in  the  encysted  form,  and  it  may  also  be 
found  free.  The  latter,  Filaria  medinensis  or  guinea  worm,  is  found  on 
the  west  coast  of  Africa  and  Arabia,  and  produces  abscesses  and  tumefac- 
tions in  the  man  and  the  dog. 

The  treatment  is  simply  cleanliness. 


Cutaneous  Affections  which  are  Caused  by  Vegetable  Parasites. 

We  know  at  the  jDresent  day  of  two  skin  diseases  in  the  dog  which 
are  ascribed  to  the  presence  of  vegetable  parasites.  These  are  favus 
and  herpes.  These  ectophytes  belong  to  the  filiform  fungi  class  (hypho- 
mj'cetes)  and  may  be  simple  or  ramified,  membranous  or  non-membran- 
ous, double  contoured,  cellular  threads  (hyphae),  which  become  mixed 
in  their  growth  and  form  a  real  fungous  bed  or  fungous  turf  (mycelium). 
These  fungous  growths  produce  at  their  ends  and  at  the  point  of  their 


Fig.   172. — Fa\'U3  spores,  magnified  450  times,     (von  Diiben.) 

short  side  branches  bead-  or  string-like  spores,  uniting  and  ligating  each 
other,  which  are  considered  as  sexual  or  multiplying  organs.  We 
cannot  make  a  strong  distinction  between  the  fungi  of  favus  and  those 
of  herpes,  but  there  is  a  difference,  as  is  seen  in  the  disease  in  its  local 
form,  and  we  have  given  a  description  of  both. 

1.  Favus. — This  fungus  is  called  achorion  Schonleinii,  and  is  devel- 
oped upon  the  skin,  between  the  epidermic  layers  in  the  hair-follicles, 
and  also  in  the  hair  itself,  and  the  secreting  tissues  of  the  claws.  It  is 
very  rare  and  generally  affects  young  animals.  The  determination  of 
the  fung-us  is  the  same  method  followed  in  trichophyton.  It  may  he 
transmitted  to  the  cat,  horse,  rabbit,  mouse,  and  human  beings,  causing 
a  characteristic  skin  affection. 

Clinical  Symptoms. — Favus  is  found  in  special  regions  of  the  body, 


47G 


DISEASES  OF  THE  SKIN 


namely,  upon  the  forehead,  back  of  the  nose,  abdomen,  and  external 
surface  of  the  hind  legs,  as  gray,  gray-yellow  or  even  saffron-yellow,  dry, 
brittle  crusts  or  eschars.  These  are  about  the  size  of  the  head  of  a  pin 
in  the  beginning,  but  gradually  by  their  growth  cover  the  entire  surface, 
and  may  finally  become  from  2  to  5  mm.  in  thickness.  They  appear  in 
the  shape  of  round  or  elliptical  scutula,  depressed  in  a  saucer-like  manner, 
generally  perforated  with  a  dull,  lustreless  hair,  which  drops  out  later  on. 
If  the  escharous  mass  is  removed  we  find  a  corresponding  depression 
with  exposed,  very  red  epidermis.  As  a  rule,  this  is  followed  by  bleeding 
and  more  or  less  itching,  and  where  the  disease  is  extensive,  the  animal 
has  an  odor  likened  to  the  urine  of  cats  or  old  cheese.  The  claws, 
when  affected,  become  thickened,  loosened,  reddened,  brittle  and  are 
shed. 

Therapeutic    Treatment. — The    treatment    of   this   disease   is   easy, 
consisting  of  removal  of  the  scutula  and  a  daily  application  of  anti- 


COCQs 


'^F^-; 


Fig.  173. — Trichophyton  tonsurans,  after  treatment  with  potassium  solutions.     Enlarged  300  times. 

parasitic  agents,  especially  tincture  of  iodine,  carbolic  acid  and  creosote 
solution,  sublimate  or  salicylic  acid  (10  per  cent,  solution  with  alcohol), 
and  tar  soap.  Chloride  of  sodium  (common  salt)  has  recently  been 
advocated  in  the  treatment  of  ring-worm.  It  is  either  to  be  applied  in 
saturated  solution  or  else  made  into  an  ointment  with  vaseline. 

Concerning  the  prophylaxis,  we  refer  you  to  the  indications  which 
are  given  later  in  herpes. 

2.  Herpes  Tonsurans. — Debilitating  herpes,  herpetic  ring,  herpetic 
eschar,  bare  herpes.  This  fungus,  which  is  said  to  be  the  cause  of  herpes, 
is  called  trichophyton  tonsurans,  and  is  found  in  large  masses  lying  on 
the  upper  portion  of  the  epidermis,  and  especially  in  the  hair  and  its 
follicle. 

Trichophyton  has  a  much  more  rapid  growth  than  achorion.     It 


AFFECTIONS  CAUSED  BY  VEGETABLE  PARASITES  477 

not  only  grows  from  one  centre,  as  in  the  other  form,  but  it  may  make 
its  appearance  in  a  number  of  new  centres  scattered  all  over  the  body, 
until  finally  the  whole  is  strewn  with  numerous,  isolated,  round-shaped 
bare  spots.  The  parasite  may  be  transmitted  to  dogs,  man,  cattle,  goats, 
cats,  pigs,  and  rabbits.  This  mushroom,  which  attacks  the  skin,  spreads 
to  the  hair  follicle.  ^Mien  the  hair  and  scales  are  put  in  a  caustic  potash 
solution,  and  examined  under  the  microscope  with  a  low  power,  large 
masses  of  spores  are  found  massed  like  strings  of  beads  (Fig.  173).  In 
isolated  cases  sometimes,  where  all  the  appearances  point  to  Tricho- 
phyton, it  is  not  found  to  be  present.  Boden  and  Almy  describe  an 
eruption  resembling  herpes,  which  resembled  round  or  oval  gray-white 
stains,  covered  with  scales,  seen  on  the  back,  flanks  and  the  lower  parts 
of  the  extremities  caused  by  the  micro-spores  audouini,  the  cause  of  head 
fungus  in  children.  This  condition  heals  very  rapidly.  The  French 
authors  claim  that  all  herpes  is  due  to  various  forms  of  fungi.  Schindelka 
claims  that  the  majority  of  cases  of  herpes  that  originate  in  man  are  due 
to  contact  with  diseased  dogs. 

Clinical  Symptoms. — The  eruptions  which  start  generally  in  the 
head,  region  of  the  lips  and  eyes,  and  more  rarely  on  the  neck  and  legs, 
are  marked  by  small,  round,  or  elongated  herpes,  which  vary  in  shape  and 
size  between  a  lentil  and  a  large  bean.  The  spots  are  hairless  and 
distinctly  circumscribed.  The  blotches  are  arranged  at  intervals  and 
are  generally  very  regular.  They  become  confluent  in  some  cases,  and 
extend  over  the  entire  body.  Affected  regions  show  peculiar  grayish- 
white  or  dirty  gray  asbestos-like  scabs  and  in  old  cases  yellowish-brown 
crusts  about  2  mm.  in  thickness.  These  crusts  may  have  some  hair 
adhering  to  them.  The  skin  under  the  crust  is  copper-red  in  color  and 
covered  with  numerous  millet-like  nodules  (swollen  hair-follicles). 
After  a  certain  time,  if  the  disease  ceases  to  spread,  the  scab  drops  off 
gradually,  and  we  see  a  bare,  scaly  herpes  upon  which  the  hair  slowly 
returns;  it  is  very  similar  and  might  easily  be  mistaken  at  this  stage  for 
alopecia  areata.  In  other  cases  we  find  the  formation  of  nodular  eleva- 
tions, semiglobular  in  shape,  very  sensitive  to  the  touch,  rough  on  the 
surface  and  brown  in  color.  They  generally  appear  on  the  head,  par- 
ticularly on  the  cheeks,  and  are  generally  very  difficult  to  treat,  follow- 
ing a  protracted  course  covering  over  one  or  two  months.  Itching  is 
constantly  present,  l:)ut  mild  in  character.  After  the  acute  symptoms 
have  subsided  the  scales  fall  off,  leaving  a  bare  space,  smooth  or  with  a 
few  scales  on  it,  and  the  hair  returns  gradually. 


R.        Ac.  salicylic,  3.0 

Alcohol,'  30.0 

Sig. — Salicylic  ointment. 


478  DISEASES  OF  THE  SKIN 


Ac.  salicylic, 

Sulphur  sublini., 

Sapo  virid., 

01.  rusci,, 

aa  10.0 

Atlep.s. 

40.0 

Sig. — Salicylic  sulphur  salve. 

Picis  Carolina, 

Sulphur  suhhm., 

Sapo  kali, 

aa  10.0 

Adeps, 

50.0 

Sig. — Tar  and  sulphur  salve. 

The  afflicted  animals  are  often  affected  with  secondary  eczema. 
This,  however,  is  produced  by  constant  scratching,  due  to  the  irritation 
of  the  disease. 

Therapeutic  Treatment. — The  treatment'  of  herpes  depends  on  the 
removal  of  the  favus.  We  must,  therefore,  clean  the  affected  part,  lift 
and  remove  all  scabs  and  eschars  by  means  of  a  thin  knife,  or  shampoo 
with  soft  soap,  following  it  up  by  a  dressing  of  some  of  the  agents  men- 
tioned under  the  head  of  jNIange. 

Prophylaxis. — The  animals  must  be  separated,  as  the  danger  of 
infection  to  both  clog  and  man  is  very  great.  The  kennels  are  to  be 
cleaned,  and  all  straw,  etc.,  l)urned,  and  the  animals  kept  away  from 
children. 

Trypanosomiasis. 

Under  this  term  we  class  numerous  infectious  diseases  peculiar  to 
tropical  countries.  These  various  conditions  are,  generally  speaking, 
due  to  a  flagellate  protozoon  present  in  the  blood  (protozoa  flagellata). 
Some  of  the  diseases,  such  as  the  nagana  of  Africa  and  the  surra  of 
India,  are  easily  transmitted  to  the  dog  by  inoculation.  The  parasite 
of  the  nagana  and  the  surra  (trypanosoma  brucei)  is  transmitted  by  the 
sting  of  certain  insects  (tsetse  fly  of  Africa  and  the  tropical  horse  fly  of 
India).  Under  the  microscope  it  is  easily  recognized  by  the  low  power. 
It  is  worm-like  in  form,  having  a  blunt  posterior  extremity,  its  length 
depending  on  the  animal  it  inhabits.     In  the  dog  it  is  extremely  short. 

The  symptoms  of  the  disease  are  elevation  of  the  temperature, 
which  may  be  intermittent,  oedematous  swellings,  especially  of  the 
posterior  extremities  and  of  the  thigh,  scrotum,  and  face;  pustular  erup- 
tions of  the  skin  which  may  heal  up  and  leave  the  animal  bald;  opacity 
of  the  cornea,  and  finally  paralysis  of  the  posterior  extremities.  Death 
generally  occurs  in  three  to  four  weeks.  Blin  states  that  when  dogs  im- 
ported into  India  and  China,  contract  the  disease  it  is  almost  invariably 
fatal,  but  native  dogs  generally  make  good  recoveries. 


TRYPANOSOMIASIS  479 

African  Horse  Sickness. — Dr.  Arnold  Theiler  finds  as  a  result  of  his 
observations  that  dogs  are  susceptible  to  African  horse  sickness  and 
further  that  the  canine  species  constitutes  a  very  important  medium 
through  which  horses  can  he  infected  with  the  disease.  This  statement 
is  combated  by  McFadyean  who  after  a  series  of  observations  has 
reached  the  conclusion  that  dogs  positively  resist  inoculation  and  that 
it  is  highly  improbable  that  dogs  act  as  a  reservoir  in  propagating  the 
disease  to  the  horse. 


TUMORS,  PARTICULARLY  THOSE  OF  THE  SKIN. 

A  thorough  description  of  tumors,  with  the  different  varieties  and 
forms,  cannot  be  discussed  here  as  explicitly  as  the  writer  would  like, 
and  he  therefore  will  confine  himself  to  such  tumors  as  are  met  with  in 
general  practice,  and  for  further  details  would  direct  the  reader  to  books 
on  general  pathology  and  morbid  anatomy. 

Tumors  are  rather  common  in  the  dog.  Of  the  various  neoformations 
carcinoma  seems  to  be  the  most  frequently  seen.  Next  is  the  fibroma, 
then  the  papilloma  and  the  sarcoma,  and  the  lipoma,  the  latter  being 
comparatively  rare.  Regarding  the  frecjuency  of  cancer,  out  of  over 
twelve  hundred  dogs  only  about  5  1  /2  per  cent,  were  affected  with 
cancer,  and  of  the  organs  attacked  they  were  in  the  following  order: 
Respiratory  apparatus,  26  per  cent.;  urino-generative  apparatus,  26 
per  cent,  digestive  apparatus,  25  per  cent.,  and  the  skin,  20  per  cent. 
As  regards  age,  Frohner  found  that  15  per  cent,  were  in  animals  under 
five  years  of  age,  25  per  cent,  between  the  ages  of  five  and  six,  34  per 
cent.;  between  seven  and  eight  years,  and  18  per  cent,  l^etween  nine  and 
ten  years,  while  4  per  cent,  were  between  eleven  and  thirteen  years. 
No  animal  under  two  years  was  found  to  be  affected  with  cancer. 

The  following  tumors  are  found  in  the  dog: 

1.  The  Fibroma. — This  neoformation  occurs  rather  frequently  in 
the  dog,  the  most  frequent  location  being  in  the  skin  and  subcutis  of  the 
head,  neck,  abdomen  and  spine.  Fibromata  are  also  found  on  the  chest 
and  extremities.  They  may  occur  singly  or  in  large  numbers.  They 
may  be  hard  or  soft  according  to  the  amount  of  intercellular  tissue  they 
contain.  They  are  usually  clearly  outlined,  rounded  with  a  smooth 
surface  (fibroma  durum),  more  rarely  soft  in  consistence,  and  not  so 
w^ell  circumscribed  (fibroma  molle,  fibroma  moUuscum).  The  latter 
is  frequently  bluish-red  with  a  network  of  veins  on  its  surface.  The 
filjroma  frequently  hangs  down,  particularly  when  it  is  in  an  inferior 
portion  of  the  body,  like  the  abdomen  (fibroma  pendulum)  (Fig.  174). 
In  parts  where  there  is  slight  movement  of  the  skin,  and  the  cutis  is 
firmly  fixed,  such  as  the  ear  or  metatarsus,  the  fibroma  assumes  a  flat, 
circular,  coin-like  appearance,  and  has  a  rough  or  granular  surface.  In 
some  cases  there  is  tumefaction  of  the  skin,  as  on  the  edge  of  the  nose, 
elbow,  tuberosity  of  the  ischium,  the  outer  part  of  the  forearm,  knee  and 
legs.  These  callosities  are  usually  called  recumbent,  bed  or  kennel 
tumors.     They  are  generally  bluish-gray  or  grayish-red  in  color,  rough- 

480 


TUMORS 


481 


ened  externally,  and  irregularly  circular.  They  vary  in  size  from  a 
small  pea  to  the  palm  of  the  hand,  are  generally  devoid  of  hair,  their  flat 
surface  being  smooth,  furrowed,  or  irregularly  elevated.  The  skin 
occasionally  develops  acne  from  pressure  or  alteration  of  the  tissue. 
Fibromata,  both  hard  and  soft,  are  not  malignant. 

Many  pathologists  are  not  inclined  to  regard  the  callosities  known 
as  bed  or  kennel  tumors  as  fibromata.  Most  definitions  of  the  term 
tumor  include  the  clause  that  thev  are  without  demonstrable  cause. 


Fig.  174. — Dependent  fibroma. 

This  would  exclude  these  callosities,  as  their  cause  is  obvious,  usually 
growing  on  prominent  parts,  exposed  to  friction  and  pressure  whenever 
the  animal  assumes  the  recumbent  position. 

2.  The  Lipoma. — These  fatty  tumors  of  the  subcutis  are  rarer  than 
fibromata.  They  are  generally  round  or  oblong  in  shape,  very  distinctly 
circumscribed,  being  separated  from  the  surrounding  structures  by  a 
layer  of  connective  tissue.  Sometimes  they  are  of  considerable  size, 
but  as  a  rule  they  are  of  very  slow  growth,  and  often  pedunculated  or 
lobular  in  outline  and  diffused  in  different  directions.  The  mixed  forms 
of  lipoma  and  fibroma  (fibrolipoma)  sometimes  grow  to  an  enormous 
31 


482  TUMORS 

size,  and  are  seen  as  nodular  collections  under  smooth  skin.  As  a  rule 
lipomata  are  found  on  the  tendons  and  their  sheaths,  the  chest,  shoulders, 
and  tail.  Frohner  found  a  lipoma  that  surrounded  the  anus  in  a  half- 
circle.     Lipomata  may  be  multiple  but  are  not  malignant. 

3.  The  Sarcoma. — A  tumor  made  up  of  embryonic  connective 
tissue,  originating  in  various  parts  of  the  body,  such  as  cartilages,  bones, 
periosteum,  adipose  tissue,  and  in  fact  any  of  the  connective  tissues  of 
the  body.  Depending  upon  the  size,  shape  and  disposition  of  the  com- 
ponent cells,  sarcomas  are  classified  as  small  and  large  round  cell,  small  and 
large  spindle  cell,  giant  cell,  melanotic  and  lympho-sarcomas.  Sarcomas 
are  generally  considered  as  malignant  tumors  (1)  because  they  usually 
show  a  tendency  to  become  large,  (2)  because  they  are  apt  to  reappear 
after  removal,  and  (3)  because  under  certain  conditions  they  are  apt  to 
form  in  other  parts  of  the  body  by  metastasis.  Their  malignant  char- 
acter is  generally  much  greater  in  proportion  to  the  size  of  their  cells 
and  the  softer  their  intercellular  substance. 

The  external  anatomical  appearance  of  a  sarcoma  does  not  always 
present  characteristic  symptoms.  In  most  cases  these  tumors  are  round, 
distinctly  circumscribed,  and  sometimes  they  form  encysted  knots,  which 
vary  in  color  and  consistency.  Their  color  depends,  as  a  rule,  on  their 
blood  vascular  supply,  and  any  blood  extravasations  which  may  have 
occurred  also  produce  certain  alterations,  so  that  on  section  a  sarcoma 
may  appear  white,  yellow,  brown,  gray,  dark  red,  and  even  entirely  black, 
as  the  melanotic  variety.  This  pigment  sarcoma,  or  melanoma,  is 
extremely  rare  in  the  dog,  although  Gray  asserts  that  it  is  very  common 
in  Yorkshires,  where  it  is  seen  in  the  form  of  small  black  excrescences 
the  size  of  a  pea.  Troutman  describes  an  interesting  melanosis  of  the 
toe  of  a  three-year-old  setter. 

The  metamorphoses  which  occur  in  the  sarcoma  are  of  some  diag- 
nostic value,  especially  the  mucous  softening,  which  leads  to  the  forma- 
tion of  cysts  and  sometimes  to  bony  deposits.  This  is  frequently  noticed 
in  sarcomas,  and  the  ulceration  of  the  adjacent  skin  and  mucous  mem- 
branes occurs  without  producing  any  active  disintegration  of  the  tumor. 
Notwithstanding  the  malignant  character  of  the  sarcoma,  it  may  remain 
in  the  same  condition  for  years,  and  never  inconvenience  the  animal,  or 
after  lying  quiescent  for  years  it  may  suddenly  begin  to  grow  with 
incredible  rapidity. 

The  myeloid  or  medullary  sarcoma  is  a  rare  form  of  tumor  which 
grows  in  the  marrow  cavity  of  the  bones.  They  have  been  noticed  in 
the  forearm,  shoulder-blade,  arm,  femur,  maxilla  and  penis.  Circum- 
scribed nodules  are  developed  in  the  medullary  cavity  which  generally 
crowd  out  the  bone  by  their  growth,  and  when  new  bone  is  formed  from 
the  periosteum,  fill  up  the  entire  cavity.     In  this  manner  we  find  enormous 


TUMORS 


483 


lumps,  or  masses,  possessing  the  firmness  and  hardness  of  bone,  and  in 
the  centre  is  found  a  soft  tumor  surrounded  by  a  bony  cyst.  Sooner  or 
later  the  soft  parts  penetrate  the  bony  envelope  and  certain  of  the  fluid 
escapes. 

4.  The  Papilloma. — A  benign  tumor  originating  from  a  hyperplasia 
of  the  fibrous  stroma  of  the  cutaneous  and  mucous  membrane,  with  a 
proportionate  formation  of  connective  tissue.  Papillomata  are  divided 
into  the  hard  and  soft  varieties. 

The  hard  papilloma  or  wart  is  a  neoformation  of  the  papillae  of  the 
skin  and  of  the  epidermis.  Warts  differ  very  much  in  size,  from  a  lentil 
to  the  size  of  a  large  pea.  The  external  covering  of  a  wart  is  very  often 
hard  and  firmer  than  that  of  the  connective  tissue,  so  that  the  surface  is 
surrounded  by  a  firm,  hard,  horny  covering  (horny  warts).     The  reverse 


Fig.  175. — Multiple  formation  of  warts. 

is  found  in  the  case  of  the  soft,  fleshy  warts.  These  little  growths  are 
found  on  the  skin  of  dogs  of  all  ages;  as  a  rule  on  the  head  and  back,  but 
also  in  other  regions,  and  they  frequently  disappear  without  any  treat- 
ment (Fig.  175).  Now  and  then  the  horny  warts  grow  to  a  very  large 
size  and  form  what  are  called  "cutaneous  horns."  Such  are  found  on 
the  forehead,  the  ear,  and  the  flanks.  They  are  generally  seen  in  old 
dogs,  and  at  times  have  a  tendency  to  be  malignant.  Enormous  nvimbers 
of  warts  are  sometimes  seen  in  the  mouth,  on  the  buccal  mucous  membrane 
and  tongue,  and  that  they  can  be  reproduced  by  inoculation  has  been 
proved  by  McFadyean  and  Holding. 

A  variety  of  the  papillomata  is  the  flat  condyloma.  These  are 
certain  marked  malformations  which  have  the  shape  of  a  papilla,  but  as 
a  rule  are  ramified  and  divided,  forming  coxcomb-like  or  cauliflower 
collections.  In  some  cases  they  appear  as  true  papillomata,  particularly 
as  a  sarcomatous  formation.  As  a  rule  they  appear  on  regions  other 
than  the  skin,  such  as  the  lips,  cheeks,  and  prepuce,  and  also  upon  the 
buccal  mucous  membrane.     They  are  generally  salient  and  bleed  easily, 


484  TUMORS 

due  to  the  large  niiml)cr  of  ])lood  vessels  they  contain,  their  softness, 
and  very  thin  epithelial  covering.  The  writer  has  noticed  that  dogs 
affected  with  condyloma  of  the  vulva  or  penis  also  show  these  formations 
quite  frequently  on  the  edges  of  the  lips.  Gratin  has  often  seen  the 
obscure  transmission  of  condylomata  from  one  dog  to  another.  This 
would  tend  to  establish  the  fact  that  this  variety  of  tumor  is  contagious. 
(See  Infectious  Genital  Tumors.) 

5.  The  Carcinoma. — By  the  term  carcinoma  we  designate  that  neo- 
formation  the  essential  feature  of  which  is  the  overgrowth  or  accumula- 
tion of  epithelial  cells,  some  of  which  have  penetrated  the  basement 
membrane,  by  root-like  projections,  into  the  underlying  or  neighboring 
structures.  It  is  the  commonest  of  all  neoplasms.  These  cells  possess 
the  peculiar  property  of  forming  metastases,  by  way  of  the  lymph 
channels,  producing  a  general  cancerous  infection  of  the  body  (carci- 
nomatosis), and  are,  therefore,  considered  malignant.  Any  organ  or 
structure  in  the  body  having  epithelium  in  its  make-up  may  be  the  seat 
of  carcinoma.  Most  cancerous  forms  are  distinguished  by  their  tendency 
to  regressive  metamorphoses.  These  include  mucoid,  colloid  and  fatty 
degeneration,  with  cystic  formation,  calcification,  cicatricial  contraction, 
and  in  superficial  carcinoma  of  the  skin  and  mucous  membranes,  ulcer- 
ative processes,  with  the  formation  of  purulent  foci.  Those  showing 
a  strong  tendency  to  spread  over  the  surface  are  termed  "phagedenic." 
Necrotic  changes  are  frecjuent,  the  ulcerating  portions  discharging  a  foul, 
sometimes  bloody,  material.  In  cases  of  some  standing  the  dog  may 
show  the  effect  of  this  process,  losing  flesh  and  showing  a  general  condition 
of  cachexia.     Carcinomata  are  generally  divided  into: 

(a)  Squamous  epithelioma,  sciuamous  cancer,  or  cellular  epithelioma. 
This  variety  occurs  in  the  cutaneous  membrane,  and  in  all  mucous 

membranes  containing  squamous  epithelium,  as  the  mouth,  throat, 
larynx,  eyelids,  ears,  cheeks,  external  genitalia,  bladder  and  urethra, 
rectum,  vagina  and  uterus.  This  form  of  cancer  is  frequently  seen  in 
old  animals.  It  is  a  peculiar  fact  that  this  cancerous  growth  may  accu- 
mulate rapidly  for  a  short  time,  and  then  remain  stationary  without 
increasing  further  in  size.  Squamovis  epitheliomata  appearing  in  the 
mucous  membranes,  especially  the  vagina,  which  deserves  special  men- 
tion, have  a  great  tendency  to  extend  superficially,  followed  by  a  cancer- 
ous disintegration,  also  by  a  constant,  bloody,  purulent  discharge. 
Ulceration  usually  takes  place  in  these  cancers,  sooner  or  later.  Some 
parts  may  be  covered  with  a  scab-like  crust,  while  other  parts  may  be 
raw  and  bleeding.     Fistula:'  frequently  form. 

(b)  Adeno-carcinoma,  or  malignant  adenoma. 

This  variety  may  originate  in  any  organ  containing  glandular 
epithelium.     It  is  probably  most  often  seen  in  the  mammary  glands  of 


TUMORS  485 

old  bitches.  This  cancer  of  the  mammaries  is  marked  by  the  following 
characteristics:  It  is  of  slow  growth,  particularly  hard  and  firm,  and  has 
a  tendency  to  remain  stationary  for  a  long  time.  In  some  regions  of  the 
glands  we  may  see  a  small,  hard  knot  developed,  which  is  not  sensitive 
to  pressure  and  shows  no  signs  of  inflammatory  action.  This  enlarge- 
ment gains  slowly  and  may  be  accompanied  by  other  knots  in  the  imme- 
diate neighborhood,  which  finally  unite  and  form  one  mass.  The  carci- 
noma at  this  stage  is  found  to  be  a  hard,  irregular,  circumscribed  tumor, 
and  united,  as  a  rule,  with  smaller  masses  by  a  thin  cord-like  enlargement 
that  lies  in  the  integument.  When  this  enlargement  is  located  very 
near  the  skin  it  shows  a  peculiar  cicatricial  contraction,  and  especially 
if  it  is  near  the  teat  this  may  be  drawn  entirely  into  the  skin.  This  is 
quite  common.  We  also  observe  great  distention  of  the  cutaneous 
veins,  which  may  even  be  varicosed.  As  a  rule,  the  enlargement  is 
rarely  confined  to  one,  but  we  may  find  scattered  through  the  gland 
numerous  lumps  or  knots  of  various  sizes.  We  also  see  in  the  mammaries 
of  the  dog  fibromas,  chondromas,  adenomas,  sarcomas,  and  cysts,  but 
these  are  much  rarer  than  carcinoma. 

It  is  hardly  possible  to  confound  these  tumors  of  the  mammaries 
\vith  inflammation  of  the  lacteal  gland.  True  acute  mammitis  occurs 
very  rarely  in  the  bitch,  and  is  indicated  by  a  circumscribed,  painful, 
very  sensitive  reddened  swelling  of  a  definite  glandular  section.  The 
section  may  undergo  complete  disintegration,  forming  an  abscess  and 
sloughing,  or  w^e  see  chronic  inflammation  with  a  formation  of  knotty 
lumps,  and  a  peculiar  cicatricial  contraction.  True  mammitis  must  not 
be  confounded  with  inflammation  of  the  lacteal  glands,  which  may 
appear  in  bitches  that  are  nursing  and  deprived  of  their  young.  The 
swelling  disappears  in  a  few  days  by  itself,  but  it  may  be  hastened  by  a 
light  diet  and  saline  purgatives.  In  very  rare  instances  there  is  a  peculiar 
condition  of  the  lacteal  glands  that  is  seen  in  bitches  that  have  had 
several  litters  of  pups.  About  forty-five  days  after  they  have  been  in 
"heat"  we  may  find  a  general  enlargement  and  filling  up  of  the  entire 
glands,  also  the  appearance  of  a  thin  milk  or  colostrum  in  the  glands, 
and  every  appearance  of  active  lactation.  This  might  lead  the  prac- 
titioner to  believe  that  the  bitch  was  in  whelp. 

The  tendency  of  carcinoma  to  become  malignant  and  cause  a  general 
infection  of  the  whole  body  is  especially  marked  in  the  soft  forms  of 
cancer,  particularly  those  having  a  tendency  to  ulceration  and  degenera- 
tion, while  the  hard  forms,  such  as  above  described  in  cancer  of  the  mam- 
maries, may  remain  months  and  even  years  after  producing  no  other 
eff"ect  than  a  gradual  enlargement.  The  process  is  generally  developed 
in  the  lymphatic  glands,  but  we  may  see  the  appearance  of  secondary 
tumor  centres  which  swell  up  without  being  accompanied  by  any  pain  or 


48G  TUMORS 

inflammation.  A  large  part  of  the  body  may  become  affected  in  this 
manner,  that  is  to  say,  there  is  a  gradual  development  of  the  process 
through  the  entire  body,  these  various  tumors  being  supplied  from  the  pri- 
mary tumor  or  carried  into  the  circulation  and  scattered  in  all  directions, 
forming  new  centres  of  development.  We  may  see  this  occur  in  cancerous 
masses  in  the  liver,  kidneys,  and  lungs,  producing  very  little  irritation 
of  the  surrounding  tissues  beyond  the  central  tumor,  but  we  find  that 
the  animal  falls  away  quickly,  becomes  emaciated,  has  weak  heart-action, 
and  presents  all  the  symptoms  of  what  is  known  as  cancerous  cachexia. 
The  prognosis  is  always  unfavorable.  Removal  of  a  cancerovis 
tumor  may  only  be  made  when  the  neighboring  lymphatic  glands  have 
not  become  affected,  and  where  the  animal  is  in  good  nutritive  condition. 
Cases  of  ulcerated  carcinoma  must  always  be  considered  unfavoral^le, 
except  in  the  form  of  cancroid,  which  has  been  already  described.  The 
treatment  of  cancer  consists  of  speedy  removal  and  keeping  the  animal 
in  as  healthy  condition  as  possible. 

6.  The  Myxoma. — A  tumor  made  up  of  mucous  or  gelatinous  connec- 
tive tissue.  They  are  apt  to  appear  on  the  head  and  back,  more  than 
any  other  place.  They  are  frecpently  multiple  primarily,  and  sometimes 
attain  great  size.  The  myxoma  is  a  benign  tumor,  but  it  may  recur  after 
incomplete  extirpation.  Usually  these  tumors  are  round  or  oblong, 
clearly  outlined  in  the  tissue,  are  elastic  on  pressure,  and  they  stand  out 
in  the  skin  in  semi-hemispherical  elevations.  The  cut  surface  is  pale, 
moist,  and  exudes  a  thin,  stringy  mucous  material  when  squeezed. 
They  are  frequently  found  combined  with  fibroma  and  sarcoma.  A 
very  characteristic  example  of  myxoma  is  described  by  Velmalage,  in 
which  he  found  from  the  neck  to  the  root  of  the  tail,  as  well  as  on  both 
sides  of  the  thorax,  the  outer  surface  of  the  hind  legs,  and  the  anterior 
region  of  the  sternum,  great  numbers  of  nodules  varying  in  size  from  a 
pea  to  a  hazel  nut,  or  even  as  large  as  a  walnut. 

7.  The  Adenoma. — One  of  the  parenchymatous  group  of  tumors, 
composed  of  glandular  epithelium,  which  may  assunie  either  the  type  of 
a  tubular  or  an  acinous  adenoma.  They  always  originate  in  some  gland, 
are  either  single  or  multiple,  and  can  be  distinguished  from  simple  glan- 
dular hypertrophy  by  the  fact  that  they  stand  out  prominently  from 
their  surroundings,  are  knotty  or  scirrhous,  or  sometimes  quite  soft. 
Their  growth  is  slow  and  they  are  seen  most  frequently  in  the  breast, 
rectum,  thyroid  and  ovary.  Adenomata  are  not  malignant,  primarily, 
but  just  as  soon  as  the  basement  membrane  is  penetrated  by  the  tumor, 
it  then  becomes  a  carcinoma,  malignant  in  character.  Cystic  degenera- 
tion is  probably  the  most  common  of  the  retrograde  processes.  When 
they  are  superficial,  we  may  have  ulcei'ation  taking  place. 

8.  The  Angioma. — A  tumor  composed   of   blood  vessels  and  their 


TUMORS  487 

contents.  According  to  the  kind  of  vessel  present,  angiomata  are 
designated  either  capillary,  cavernous  or  aneurysmal.  The  capillary 
type  is  the  most  common.  In  the  dog  these  tumors  may  frequently 
escape  notice,  on  account  of  the  color  of  the  skin  and  the  hair  obscuring 
them.  They  may  occur  in  any  part  of  the  skin,  and  some  attain  the 
size  of  a  hen's  egg.  They  are  non-encapsulated,  but  usually  only  involve 
the  corium.  They  are  flat,  but  slightly  elevated,  and  the  color  varies 
from  a  light  to  a  dark  red.  Shindelka  observed  a  nsevus  vasculosum 
(birth-mark)  on  the  right  side  of  the  head  of  a  white  poodle,  the  formation 
being  irregularly  outlined,  bluish-red  in  color,  and  involving  the  forehead, 
temporal  region,  and  a  portion  of  the  eyelids.  The  author  saw  a  similar 
condition  on  the  chest  of  a  Russian  wolf-hound.  Simple  enlargement 
of  the  veins  has  been  observed  on  the  scrotum. 

9.  The  Myoma. — A  tumor  made  up  of  muscular  tissue.  According 
to  the  variety  of  muscle  making  up  the  tumor  they  are  designated  leio- 
myoma (smooth  or  involuntary),  or  rhabdomyoma  (striated  or  volun- 
tary. Myomata  are  rare,  but  may  originate  in  any  structure  containing 
muscular  fibres,  voluntary  or  involuntary.  However,  these  tumors 
may  exist  in  structures  normally  having  no  mucsular  fibres  in  them,  but 
these  cases  are  rare.  When  a  myoma  exists  in  normal  muscle,  it  some- 
times so  closely  resembles  the  normal  muscle  as  to  be  distinguishable 
with  difficulty. 

10.  The  Osteoma. — A  bone  tumor,  either  compact  or  spongy,  and 
usually  developed  on  the  body  of  a  bone.  As  a  rule  it  occurs  on  the 
periosteum,  but  more  rarely  in  the  muscles,  fasciae,  tendons,  and  still 
more  rarely  in  the  thyroid  glands.  (This  last  condition  was  described 
by  Siedamgrotsky.)  They  are  usually  recognizable  by  their  location 
and  consistency.  They  frequently  occur  in  combination  with  sarcomata 
and  chondromata.  The  size  varies,  the  author  having  seen  an  old  dog 
in  which  he  found  osteomata  nearly  as  large  as  a  hen's  egg.  These  were 
remarkable  for  their  extremely  regular  surface,  and  were  attached  by 
distended  tendinous  tissue  to  the  left  of  the  transverse  prolongation  of 
the  fifth  cervical  vertebra,  but  were  removed  without  any  bad  results. 
As  a  rule  osteomata  are  removed  only  when  they  are  closely  connected 
with  the  bone,  and  when  they  are  likely  to  cause  a  great  deal  of  trouble. 

11.  The  Chondroma. — A  tumor  made  up  of  cartilage  cells,  usually 
of  the  hyaline  variety,  but  sometimes  they  are  observed  to  be  of  the 
fibrous  or  yellow  elastic  type.  They  may  arise  from  any  structure  con- 
taining cartilage,  such  as  the  trachea,  nasal  septum,  ribs  and  the  ends 
of  bones.  They  are  frequently  met  with  in  the  shafts  of  long  bones 
(enchondroma) .  Usually  they  do  not  grow  to  a  very  large  size,  and  are 
non-malignant,  although  they  may  be  multiple  primarily. 


488  TUMORS 

Infectious  Genital  Tumors. 

This  condition  seems  to  be  almost  entirely  confined  to  the  higher 
bred  animals.  Particularly  since  careful  selection  in  breeding  has  been 
made,  and  the  best  bred  dogs  are  apt  to  be  infected.  It  was  first  observed 
on  the  continent  and  later  in  Great  Britain,  and  then  from  the  large 
number  of  dogs  that  have  been  imported  into  the  United  States,  it  made 
its  appearance  in  America.  Its  peculiar  character  of  reaching  its  highest 
development  in  three  months  or  about  that  time  and  then  commencing 
a  retrograde  degeneration  and  healing  up,  has  to  a  certain  extent  checked 
its  development  and  has  a  tendency  to  keep  it  within  bounds,  and  also 
that  it  is  rarely  seen  in  common  bred  dogs.  Its  chief  mode  of  dissemina- 
tion seems  to  be  from  the  male,  for  when  a  particularly  good  stud-dog 
is  affected  numbers  of  bitches  become  inoculated,  thus  the  disease  is 
carried  in  all  directions. 

The  disease  commences  by  a  circumscribed  tumefaction,  deep  red 
in  color  and  by  a  gradual  elevation  of  the  tissue  and  develops  into  round 
nodular  tumors,  these  become  lobular  masses,  are  grayish-pink,  varying 
to  purplish  red;  they  bleed  easily  on  th-e  slightest  manipulation.  There 
is  more  or  less  discharge  of  bloody  muco-purulent  fluid  from  the  prepuce, 
and  that  organ  is  sw^ollen  and  deepened  in  color  at  the  free  portion  (see 
Plate).  If  there  is  a  chance  to  observe  the  disease  from  the  onset,  it  is 
found  to  commence  with  a  slight  tumefaction  of  the  tissues  and  formation 
of  small  firm  nodules,  which  increase  slowly  and  finally  develop  into 
rounded  masses;  then  these  masses  become  softened,  break  down  and 
leave  a  deep  ulcer  with  raised  edges  from  which  a  thin  tenacious  discharge 
flows. 

In  the  bitch  the  tumors  are  rarely  noticed  until  a  discharge  is  seen 
at  the  vagina,  or  she  shows  great  pain  during  copulation  and  will  generally 
refuse  to  take  the  male.  A  digital  examination  shows  a  number  of 
tumors  in  the  form  of  elevations  either  sessile  or  pedunculated,  in  severe 
cases  the  walls  of  the  vagina  are  covered  with  them.  The  sessile  seems  to 
be  commonest  in  the  bitch;  they  lie,  as  a  rule,  well  up  in  the  anterior 
portion  of  the  vagina. 

The  tumors  will  break  down  and  disappear,  but  in  the  bitch  they 
invariably  leave  a  cicatricial  contraction  so  that  while  the  bitch  may 
become  pregnant  she  has  great  difficulty  in  parturition,  the  vaginal  walls 
in  that  particular  portion  becoming  inelastic.  In  other  cases  if  the 
bitch  becomes  inoculated  ])y  the  dog  the  tumors  grow  so  rapidly  that 
they  practically  close  the  vagina  so  as  to  produce  dystocia. 

That  this  disease  is  contagious  there  is  not  the  slightest  doubt,  and 
that  it  is  easily  transmitted  experimentally  has  been  shown  by  Wash- 
burn and  Smith,  who  state  that,  "For  the  first  few  days  after  inoculation 


z 


INFECTIVE  TUMOR   OF   DOGS   {natural  size.) 
Circle  I  includes  area  slunvn  belo~M.       Circle  a  shows  fully  developed  stage. 


■#*^ 


>\    "^^M^ 


??f 


INFECTIVE   TUMOR   OF   DOGS    {the  initial  stage.) 
Camera  drawings,  lo7u power.     Clarke,  Protozoa  and  Diseases.     Bailliere,  Tindall  ^r'  Cox,  London. 


INFECTIOUS  GENITAL  TUMORS  489 

a  swelling  can  be  felt,  partly  due  to  the  fragments  of  the  tumor  introduced 
and  partly  to  inflammatory  exudation.  In  some  cases  this  swelling 
completely  subsides,  so  that  nothing  can  be  felt  until  the  appearance  of 
a  small  nodule  indicates  that  inoculation  has  been  successful.  In  other 
cases  the  swelling  persists,  and  it  is  difficult  to  decide  whether  the  inocu- 
lation has  been  successful  until  a  definite  increase  in  the  size  of  the 
swelling  has  taken  place.  The  usual  time  at  which  there  is  distinct 
evidence  of  the  first  appearance  of  the  growth  after  inoculation  is  about 
three  weeks,  but  it  varies  between  twelve  days  and  a  month.  *  *  * 
The  small  firm  nodules  which  first  appear  gradually  increase  in  size,  and 
form  rounded  lobulated  masses.  At  the  commencement  they  are  freely 
movable  beneath  the  skin,  but  at  a  later  period  the  latter  become  thinned 
out,  of  a  bluish-red  color,  and  firmly  adherent  to  the  growths.  *  *  * 
The  maximum  growth  is  attained  in  about  three  months.  A  curious 
regularity  obtains  in  this  respect.  *  *  *  Having  reached  this  stage, 
retrograde  stages  are  not  long  in  appearing;  the  growth  becomes  soft 
and  flabby,  and  slowly  dwindles  until  nothing  is  left  to  indicate  its 
former  presence.  *  *  *  j^  nearly  half  the  cases  the  subsidence  of  the 
tumor  was  accompanied  by  ulceration;  the  thinned-out  reddened  skin 
giving  way  over  the  growth,  which  has  previously  undergone  softening, 
and  there  results  a  deep  ulcer,  from  which  a  thin  grumous  discharge  flows. 
Even  when  these  retrograde  changes  are  occurring,  fresh  growths  occa- 
sionally take  place  at  the  periphery  of  the  tumor. " 

Clake,  who  has  carefully  examined  the  tumors,  likens  them  to  the 
alveolar  sarcoma  of  the  human  breast  and  classes  them  as  granulomata. 
He  describes  three  stages  and  shows  marked  changes  in  each.  And 
concludes  that  they  may  be  divided  into  three  stages: 

1.  "The  early  granulation-tissue  stage — i.e.,  a  filling  out  of  the 
shrunken  connective-tissue  cells. 

2.  "A  stage  in  which  the  granulation-tissue  cells  have  assumed  the 
character  of  sarcoma-cells.  Some  of  these  cells  exhibit  a  mitotic  activity 
comparable  to  that  seen  in  the  earlier  stages  of  invasion  of  the  cells  of 
the  cornea  by  the  protozoa  of  vaccinia  in  their  hyaline  or  chromidial 
phase.  Among  the  tumor-cells  in  this  stage  are  bodies  of  typical  proto- 
zoon  characters;  and — 

3.  ''A  final  stage  in  which  chromidial  parasites  escape  from  the 
nuclei  of  the  tumor-cells,  rapidly  enlarge,  become  nucleated,  and  subdi- 
vide; this  process  terminates  in  the  formation  of  minute  bodies,  most  of 
which  are  in  the  chromidial  condition." 

Treatment. — In  the  male  it  is  comparatively  easy.  If  the  tumor 
has  not  broken  down  it  should  be  removed  by  filling  the  prepuce  with 
cocaine  solution,  then  have  an  assistant  retract  the  prepuce  and  expose 
the  free  portion  of  the  penis.     The  tumors  must  be  freely  cut  away  with 


490 


TUMORS 


a  pair  of  curved  scissors;  then  to  the  excised  portion  of  tissue  apply  the 
thermo-cautery,  or  with  a  camel's  hair  brush  apply  pure  carbolic  acid 
which  should  be  neutralized  immediately  with  an  alkaline  solution. 
There  is  always  considerable  hemorrhage,  but  this  is  easily  controlled. 
French  advises,  if  there  should  be  great  hemorrhage,  to  take  one  or  two 
stitches  in  the  mucosa.  This  is  to  be  done  only  where  the  hemorrhage 
is  extreme  and  the  stitches  to  be  removed  not  later  than  twenty-four 
hours  afterwards  as  the  sutures  cause  great  irritation.  The  non-irritating 
substitutes  for  nitrate  of  silver  such  as  the  silver  proteids  and  albuminates 
are  particularly  useful  in  this  condition  and  should  be  applied  locally  in 
the  male  and  injected  freely  in  solution  in  the  bitch. 


Fig.    176. Chronic  ulcer. 

The  male,  if  treated  early,  generally  recovers  in  three  or  four  months, 
in  the  bitch  if  the  vagina  is  involved  to  any  great  extent  it  is  not  wise  to 
breed  her.  If  asked  to  give  an  opinion  as  to  her  i3urchase  as  a  brood 
bitch  it  would  he  well  to  advise  against  it. 

General  Therapeutics  of  Tumors. — The  treatment  of  tumors  of  the 
mouth,  anus  and  mammar}'  glands  has  already  been  taken  up  and 
the  reader  is  referred  to  those  conditions  under  their  respective  titles. 
The  internal  medicinal  treatment  of  tumors  by  preparations  of  iodine 
may  be  used  in  cases  of  goitre.  In  carcinoma  and  sarcoma  we  may  give 
arsenic  in  the  form  of  a  solution  of  mercury,  iodine,  and  arsenic  (Fowler's 
or  Donovan's  solution). 

Surgical  Treatment. — This  is  generally  palliative  in  cases  where  the 
tumor  is  difficult  to  reach,  being  restricted  to  the  prevention  of  hemor- 
rhage, suppuration,  and  a  fetid  odor. 


Wm 


INFECTIVE   TUMOR   OF   DOGS    {the  fully  developed  stage.) 

I.  Cells  dhtetided  by  cell-inchisions.     2  and 3.  Cells  ivith  acth/e  nuclei.     4.  Cells  luith  amcehoid  bodies 

close  to  empty  nuclei.      Camera  draiving,  lo7v  power.     Clarke,  Protozoa  and  Diseases. 

Bailliere,  Tindall  &'  Cox,  London. 


SURGERY  OF  TUMORS  491 

Tampons  of  tow  which  have  hoon  saturated  in  a  solution  of  chloride 
of  iron  and  injections  (where  there  is  an  opening)  of  subsulphate  of  iron, 
1  to  90. 

This  palliative  method  is  only  indicated  where  a  radical  operation 
cannot  be  performed  from  some  cause  or  location  of  the  tumor  and  where 
the  owner  wishes  to  keep  the  animal  alive  as  long  as  possible  without 
surgical  interference. 

The  methods  of  radical  removal  of  a  tumor  are  as  follows  (these  do 
not  include  torsion  or  twisting) : 

Ligation. — This  method  may  be  applied  in  all  cases  where  the  base 
of  the  tumor  is  not  too  broad  and  if  it  has  not  penetrated  deeply  into 
the  tissues.  It  is  useful  in  many  forms  of  warts,  fibromas,  and  sarcomas; 
but,  as  a  rule,  it  is  objectionable  because  it  acts  slowly,  is  extremely 
painful,  produces  great  inflammation  with  suppuration,  and  the  tumor 
has  a  tendency  to  return.  The  general  mode  of  procedure  in  this  opera- 
tion is  to  ligate  the  base  of  the  tumor  with  a  strong  silk  thread  or  rubber 
band  wound  several  times.  These  growths  can  also  be  subdivided  by 
means  of  the  ecraseur,  using  either  the  chain  or  wire.  The  chain  of  the 
ecraseur  is  put  around  the  base  of  the  tumor  and  greatly  tightened  by 


Fig.    177. — Wire   ecraseur. 


means  of  the  instrument,  when  the  tissues  are  gradually  crushed.  The 
writer  has  used  the  wire-loop  shown  in  its  simplest  form  in  Fig.  177 
for  the  removal  of  epulides.  The  bleeding,  as  a  rule,  is  very  slight  if 
the  crushing  is  done  slowly,  but  there  is  always  clanger  of  a  recurrence 
of  this  condition.  We  must,  therefore,  touch  the  open  space  left  after 
the  removal  of  the  tumor  with  a  thermo-cautery. 

Cauterization. — We  may  destroy  tumors  of  the  cutaneous  or  mucous 
membrane,  flat  warts,  etc.,  by  means  of  the  thermo-cautery,  or  we  may 
use  some  of  the  various  cauterizing  substances.  The  thermo-cautery 
has  the  advantage  of  being  kept  at  an  even  heat  for  a  long  time,  and  on 
account  of  this  steadiness  is  especially  valuable  in  controlling  hemorrhages 

The  caustic  chemical  substances,  such  as  burnt  alum,  caustic  potash, 
sulphate  of  copper,  chromic  acid,  chloride  of  zinc,  and  nitric  acid,  are  not 
especially  valuable  in  the  therapeutic  treatment  of  tumors. 

Removal — Extirpation. — This  method  is  the  best  one  to  follow  in 
all  large  tumors  which  are  easily  reduced.  Various  modifications  are 
possible,  according  to  the  form  and  location  of  the  tvimor,  but  the  follow- 
ing is  the  general  mode  of  procedure: 

In  making  the  incision  the  cut  should  be  made  by  an  ordinary 
scalpel  between  the  tumor  and  soft  parts,  making  the  incision,  if  possible, 


492 


TUMORS 


in  the  direction  of  the  hair  and  of  the  large  blood  vessels.  After  the 
extirpation  of  the  tumor,  the  cavity  should  be  cleared  of  all  loose  tissue 
by  means  of  a  pair  of  scissors  or  scraped  with  a  curette.  Ligate  all 
the  blood  vessels.  Clean  the  wound  of  blood  clots,  and  touch  the 
whole  freshly  cut  surface  with  pure  carbolic  acid,  as  it  frequently  facili- 
tates healing  by  first  intention.     Then   bring  together  the  edges  of  the 


Fig.    178. — Manner  of   tying   the  mouth. 

wound  by  means  of  sutures.  Place  over  the  wound  an  antiseptic 
dressing. 

Anaesthesia. — We  have  already  given  information  as  regards  the  last 
three  points  of  the  operation.  We  must  confine  the  animal,  in  all  opera- 
tions, in  such  a  way  as  to  prevent  him  from  biting  or  moving  that  part  of 
the  body  which  is  operated  upon.  It  is  best  to  place  a  leather  strap  or 
broad  cotton  tape  bandage  around  the  mouth  (see  Fig.  178)  and  have 
an  assistant  to  hold  it.  This  method  is  preferable  to  strapping  with 
cord,  etc.  Hobday,  Gray  and  Berdez  have  constructed  special  hobbles 
and  operating-tables  which  are  to  be  used  in  hospitals. 

In  very  serious  operations,  accompanied  by  great  pain,  it  is  advisable 
to  place  the  animal  under  the  influence  of  some  anaesthetic  (except  in 
slight  operations  of  the  eye,  in  which  local  anaesthesia  with  cocaine  is 
sufficient).  For  general  anaesthesia  we  use  ether  or  chloroform,  or  in 
cases  where  small  tumors  or  warts,  etc.,  are  to  be  removed.  In  that  case 
for  local  anaesthesia  we  use  the  spray  of  ether  or  ethyl  chloride  or  local 
subcutaneous  injections  of  solutions  of  cocaine  hydrochlorate.  The 
inhalers  used  in  anaesthesia  consist  of  modifications  of  cones  or  cylinders, 
the  commonest  being  a  cylinder  of  tin  with  open  perforated  tin  or  wire 
at  one  end  and  containing  a  sponge  to  hold  the  anaesthetic.  This  is 
placed  over  the  nose  of  the  animal.  A  large  number  of  modifications  of 
this  simple  apparatus  are  used,  varying  from  a  wire  muzzle  or  an 
ordinary  tumbler  or  a  flower  pot  to  the  elaborate  apparatus  advised  by 
Hobday  and  described  in  the  "Surgical  Diseases  of  the  Dog  and  Cat.'* 
This  apparatus  consists  of  a  mask  that  has  the  form  of  an  elongated  blunt 
cone,  having  a  stopcock  at  one  end  where  the  tube  enters  that  carries 


SURGERY  OF  TUMORS  493 

the  anaesthetic  into  the  apparatus.  This  is  fixed  on  the  head  by  means 
of  a  collar,  and  a  circular  continuation  of  the  cone  made  of  soft  cloth, 
which  is  adjustable,  is  fitted  over  the  face.  A  container  with  a  broad 
base  to  prevent  any  chance  of  it  being  overturned  contains  the  anaes- 
thetic. This  container  has  two  openings — one  to  connect  the  tube  and 
the  other  to  allow  the  admission  of  air  to  mix  with  the  vapor  of  the 
anaesthetic.  Connecting  the  container  and  the  mask  is  a  bulb  apparatus 
usually  seen  on  the  thermo-cautery. 

The  muzzle  apparatus  is  fixed  on  the  animal's  head,  and  by  means 
of  the  bulb  the  mixed  vapor  is  blown  into  the  muzzle  and  directly  on  the 
animal's  nose,  thus  preventing  the  irritation  of  the  direct  contact  of  the 
ether  or  chloroform.  By  means  of  the  stop-cock  the  supply  of  vapor 
can  be  stopped  instantly,  or,  if  need  be,  the  whole  apparatus  can  be 
slipped  over  the  animal's  head  or  the  rubber  tube  can  be  pulled  from 
the  container  and  a  supply  or  pure  air  blown  directly  on  the  animal's 
nostrils. 

In  the  administration  of  the  anaesthetic  we  must  take  care  that  a 
certain  amount  of  air  is  inhaled  with  the  vapor  of  the  anaesthetic.  The 
pulse,  respiration,  and  reaction  of  the  eyelids  must  be  watched  at  the 
same  time.  After  a  few  inhalations  we  notice  a  period  of  excitement 
which  is  marked  by  great  restlessness,  howling,  groaning,  and,  in  rare 
cases,  delirium.  This  is  followed  in  a  short  time  by  a  period  of  depression, 
and  after  that  the  narcotic  condition  is  completely  established.  The 
cornea  has  now  become  insensible — that  is  to  say,  there  is  no  reflex 
action  or  closing  of  the  eyelids  when  touched.  The  muscles  are  now 
entirely  relaxed,  faeces  and  urine  are  discharged  involuntarily.  This 
result  is  not  always  even  or  regular,  but  depends  to  a  large  extent  on 
which  of  the  above-mentioned  remedies  is  used.  For  instance,  in  using 
ether  the  stage  of  excitement  is  usually  prolonged  (twenty  to  forty 
minutes)  and  in  the  stage  of  depression  reflex  excitement  does  not  dis- 
appear immediately.  Chloroform  produces  much  quicker  results,  and,  as 
a  rule,  answers  fairly  well,  but  it  has  one  disadvantage — the  attendant 
or  administrator  must  be  very  careful  not  to  push  it  too  far,  or  it  is  apt 
to  produce  paralysis  of  the  lungs  or  stop  the  action  of  the  heart,  causing 
death.  We  prefer  to  use  a  combined  narcotic  in  the  form  of  a  subcutane- 
ous injection.  This  injection  consists  of  0.01  to  0.5  of  morphia  muriate 
dissolved  in  water,  and  in  order  to  prevent  the  possibility  of  too  large  a 
dose  causing  paralysis  of  the  heart  0.002  to  0.005  of  atropia  sulphate 
should  be  added  one-ciuarter  to  one-half  an  hour  before  the  operation. 
Afterward  the  writer  has  found  it  necessary  to  carefully  administer 
chloroform  until  the  animal  is  completely  anaesthetized,  then  follow  up  the 
operation  with  ether  alone  or  alternating  with  the  inhalation  of  ether  and 
then  chloroform.     The  narcotic  stage  is  mild,  the  period  of  excitement 


494  TUMORS 

short.  Some  prefer  Billroth's  mixture  (chloroform  3  parts,  ether  and 
alcohol  1  part  of  each) ;  there  is  also  Wachsmuth's  mixture  (chloroform  5 
parts,  oleum  terebinthinae  recti  1  part).  In  England  the  A.  C.  E.  mixture 
(ethyl  alcohol  1  part,  chloroform  2  parts,  and  ether  3  parts)  is  largely  used 
In  America  the  morphia-ether  procedure,  that  of  giving  from  one-half  to 
one  grain  of  morphia  twenty-five  minutes  before  the  operation  and  then 
giving  ether  during  the  operation  is  largely  used.  It  is  safe,  its  chief 
objection  being  that  it  induces  more  of  less  preliminary  excitement  and 
salivation.  Cocaine  for  local  application  as  in  the  eye  is  harmless  as  a 
rule,  but  subcutaneous  injections  of  a  large  amount  of  concentrated 
sokitions  for  local  anaesthesia  should  be  avoided  as  they  are  liable  to 
cause  grave  symptoms  of  intoxication  or  even  death.  This  may  also 
occur  in  the  administration  of  cocaine  in  suppositories  in  tenesmus  and 
prolapsus  of  the  rectum  in  young  dogs,  and  in  very  small  dogs  a  dose  of 
cocaine  ranging  from  0.025  to  0.05  may  produce  indications  of  cocaine 
poisoning;  consequently  in  weak  young  animals  of  the  smaller  breeds  it 
should  be  used  with  great  care.  Milder  local  anaesthetics,  such  as  acoin, 
eucaine,  stovaine,  novocaine,  are  recommended.  As  to  the  so-called  lumbar 
anaesthesia  of  the  spinal  cord,  it  has  been  recommended  for  painless 
operations  of  the  abdomen.  The  operation  consists  in  putting  the  hyper- 
dermic  needle  in  the  lumbo-sacral  fossa,  which  is  between  the  median 
iliac  angles.  Pfeiffer  uses  a  2  to  3  per  cent,  solution  of  stovaine;  the 
weight  of  the  dog  determines  the  dose  (0.007  to  each  kilo.). 

The  use  of  various  animal  sera,  such  as  the  anti-streptococcic  and 
polyvalent  sera,  have  been  offered  as  a  possible  means  of  preventing 
wxnmd  infection.  These  sera  undoubtedly  are  valualjle  and  will  ulti- 
mately, when  better  understood,  be  of  great  benefit  therapeutically.  At 
present,  however,  they  are  still  in  a  state  of  evolution. 


INDEX 


A  BDOMEN,  fatty  deposits  in,  101 
■*^  puncture  of,  103 

Abdominal  dropsy,  99 

hernia,  381 
Abscess  of  the  anal  glands,  80 

of  the  kidneys,  187 

of  the  liver,  109 

of  the  neck,  45 

of  the  parotid,  44 

of  the  sclerotic  membrane,  409 
Abscesses,  perinephritic,  187 
Absence  or  loss  of  the  sexual  desire,  222 
Acarus  demodex  folliculorum,  469 

raystax,  82 
Acetic  acid  test,  179 
Acne,  455 

Acute  catarrh  of  the  bowels,  52 
of  the  bronchia,  138 
of  the  stomach,  52 

diffuse  peritonitis,  96 

dyspepsia,  52 

endocorditis,  158 

inflammation  of  the  kidneys,  181 

intestinal  catarrh,  58 

laryngeal  catarrh,  133 

laryngitis,  133 

miliary  tuberculosis,  303 

nephritis,   181 

parenchymatous  hepatitis,   108 

peritonitis,  95 

synovial  inflammation  of  the  joints, 
338 
Adenoma,  486 
Affection  of  the  eyelids,  395 
African  horse  sickness,  479 
Air-passages,  diseases  of,  115 
Albumin,  digestion  of,  22 

in  urine,  179 
Alopecia,  458 
Alveolar  Periostites,  38 
Amaurosis,  425 
Amblyopia,  425 
Amount  of  urine,  173 
Amputation  of  bones,  324 

of  tail,  375 
Amyloid  kidney,  186 

Hver,  110 
Anaemia,  312 

chlorosis,  312 

of  the  brain,  236 
Anaesthesia,  480 
Anal  glands,  abscesses  of,  80 

pouches,  inflammation  of,  78 

tumors  of,  78 
Angina  catarrhalis,  46 


Angioma,  486 

Animal    parasites,    cutaneous    affections 
caused  by,  461 

of  the  kidney,  190 
Anterior  chamber,  dropsy  of,  423 
Anomalies  of  the  iris,  422 
Anthracosis  pulmonum,  146 
Anthrax,  289 
Anus,  imperforate,  78 

prolapsus  of,  74 

stitching  of,  77 
Aortic  valve,  disease  of,  160 

opening,  stenosis  of,  162 
Aphtha;,^  34 
Apoplexia,  237 
Areca  nut,  92 
Arsenical  poisoning,  111 
Arthritis  deformans,  341 

rheumatic,  340 
Articulations,  diseases  of,  337 
Ascites,  99 

Aseptic  wound  fever,  361 
Asthma,  146 
Ataxia,  334 
Atresia  ani,  75 

Atrophic  conditions  of  cutaneous  mem- 
brane, 458 
Auscultation  of  the  lungs,  125 

of  the  thorax,  110 
Auditory  canal,  424 


DACTERIA  in  the  urine,  159,  172 
^     Basedow's  disease,  263 
Bench-show  distemper,  282 
Bile  color  in  urine,  181 
Bismuth  test,  180 
Bitch,  castration  of,  223 

inguinal  hernia  in,  337 

menstruation  of,  171 

passing  the  catheter  in,  170 
Bite,  frost,  370 

snake,  373 
Black  cataract,  425 
Bladder,  catarrh  of,  191 

cramp  of,  202 

debility  of,  195 

dilatation  of,  196 

diseases  of,  191 

examination  of,  172 

neo-formation  of,  203 

paralysis  of,  195 

retroflection  of,  203 

stone  in,  197 

urine  in,  173 


49^ 


496 


INDEX 


Bleeding  at  the  nose,  129 
Blennorrhoea  of  the  eyelids,  103 
Blood-boils,  317 

-corpuscles  in  urine,  158 

filaria  in,  167 
Bloodvessels,  inflammation  of,  308 
Boils,  385 
Body,  increased  temperature  of,  7 

structure  and  constitution  of,  3 

subnormal  temperature  of,  9 
Bones,  diseases  of,  323 

fractures  of,  325 

neo-formations  of,  33G 

softenino;  of,  325 

tumors  of,  336 

union  of  fractured,  328 
Bothriocephalus,  82 

l)ubius,  82 

cordatus,  82 

fuscus,  82 

latus,  82 

reticulatus,  82 
Bowels    and    peritoneum,    physical    ex- 
amination of,  25 

acute  catarrh  of,  59 

chronic  catarrh  of,  62 

distention  of,  with  gas,  88 
Brain,  anaemia  of,  236 

concussion  of,  238 

diseases  of,  235 

cedema  and  parasites  of,  242 

hyperaemia  of,  235 

inflammation  of,  239 

rare  diseases  of,  241 

traumatic  lesions  of,  238 
Brom-ether,  348 
Bronchia,  acute  catarrh  of,  138 

chronic  catarrh  of,  121,  122 
Bronchial  asthma,  146 

breathing.  111 

catarrh,  infectious,  235 

tubes,  diseases  of,  137 
Bronchitis,  137 

parisitic,  140 
Bronchocele,  264 
Broncho-pneumonia,  141 
Bruises,  317 

Bruits,  of  the  heart,  156 
Buccal  fungi,  43 
Burns  and  scalds,  369 
Bursa  mucosa,  diseases  of,  356 


/CACHEXIA  stnimipriva,  264 
^^     Cesarean  section,  220 
Calculi,  uric,  197 
Cancerous  tumor,  482 
Cancer  of  prostate,  206 

of  stomach,  57 
Cania  bubo,  461 
Canker,  external,  432 

internal,  434 

of  the  ear,  parasitic,  439 
Carbolic-acid  poisoning,  98 


Carcinoma,  484 
Caries"  of  the  teeth,  38 
Cartilaginous  tumor,  333 
Castration,  210,  388 
in  the  bitch,  223 
of  the  male,  210 
Catarrh,  acute,  of  bronchia,  138 
laryngeal,   133 
of  intestines,  58 
chronic,  of  bowels,  60 
of  bronchia,  137 
infectious  bronchial,  283 
nasal,  128 
of  frontal  sinusis,  130 

of  larynx,  133 
of  the  bladder,  191 
of  the  nose,  128 
of  the  stomach,  52 
of  the  windpipe  and  bronchia,   137 
Catarrhal  conjunctivitis,  402 

inflammation  of  the  lungs,  141 
jaundice,  104 
metritis,  215 
ophthalmia,  403 
pneumonia,  141 
Catalepsy,  262 
Cataract,  416 

black,  425 
Catheter,  passing  of,  169 
Cavity  of  the  mouth,  malformations  of, 

41 
Ceratopsylus  canis,  462 
Cerebral  hemorrhage,  237 
Cerebro-spinalis,  243 

-spinal  meningitis,  243 
Cerebrum,  inflammation  of,  239 
Cestodes,  84 
Chest,  dimensions  of,  49 
dropsy  of  the,  151 
puncture  of  the  cavity  of  the,  150 
shape  of  the  cavity  of  the,  119 
sensitiveness  to  pressure,  119 
Chloroform,  483 
Chlorosis,  312 
Chorea,  259 

Chronic  catarrh  of  the  liowels,  58 
of  the  bronchia,  137 
of  the  larynx,  135 
of  the  nose,  128 
of  the  stomach,  53 
constipation,  72 
dyspepsia,  53 
eczema,  448 
hydrocephalus,  241 
induration  of  the  lungs,  143 
inflammation  of  tlie  kidneys,  184 

of  the  spinal  cord,  246 
interstital  hepatitis,  108 
pneumonia,  143,  145 
nephritis,  184 
laryngitis,  133 
nephritis,  184 

parenchymatous  nephritis,  184 
peritonitis,  98 


INDEX 


497 


Chronic  prostatis,  204 

serous   inflammation   of   the   joints. 
338 

tuberculosis,  305 
Circulatory  apparatus,    diseases  of  the, 

154 
Circumscribed  peritonitis,  97 

phlegmone,  359 
Cirrhosis  of  the  liver,  108 
Claws  and  foot-pads,  diseases  of  the,  378 
Claws,  inflamed,  379 

ingrowinji,  378 
Closure  of  the  evelids,  395 
Cold  in  the  head,  128 
Collections  of  urine  in  the  abdomen  after 
rupture  of  the  bladder,  198 
in  the  bladder,  195 
Color  of  urine,  174 
Com])ression  of  the  spinal  cord,  250 
Concussion  of  the  brain,  238 

spinal  cord,  251 
Condition  of  the  mouth  and  throat,  12 

nutritive,  3 

the  physical,  1 
Condroma,  487 
Congestion  of  the  brain,  238 

of  the  liver,  104 

of  the  lungs,  145 
Congestive  hypersemia  of  the  liver,  109 
Conjunctiva,  diseases  of,  401 

inflammation  of,  401 
Conjunctivitis,  401 

catarrhal,  402 

foUicularis  of  the  membrane  nicitans, 
399 

in  distemper,  234 

purulent,  403 
Consciousness,  disturbance  of,  228 
Constipation,  29,  64 

hcronic,  72 
Constitutional  diseases,  312 
Contagious  catarrhal  fever,  267 
Contraction  of  the  intestines,  65 
Controlling  hemorrhage,  364 
Contusions,  367 

and  wounds  of  the  pads,  380 

of  the  joints,  345 
Convulsions,  233 

of  the  diaphragm,  263 
Convulsive  cough,  135 
Cornea,  abscesses  of  the,  409 

diseases  of  the,  406 

dermoid  of,  413 

injuries  of,  414 

parendrvmatous     inflammation      of 
the,  408 

ulceration  of  the,  410 
Coryza,  128 
Costiveness,  64 
Cough,  122 

chronic  irritable,  135 
Coverings  of  the  brain,  diseases  of,  235 
Cramp,  cvstic,  202 

of  the  bladder,  202 


Croupal  memljranes,  46 

pneumonia,  146 
Croupous  inflammation  of  the  lungs,  146 
Crystalline  lens,  diseases  of,  416 

extraction  of,  419 
Cutaneous  affections  caused  by  animal 
parasites,  465 
caused  by  vegetable  parasites, 
475 
membrane,  inflammaotry  conditions 

of,  441 
membranes,  atrophic  conditions  of, 

458 
tumors,  480 
Cuterebro  emasculator,  211 
Cystic  stones,  197 
Cysticerous  and  trichina,  353 
Cystitis,  191 
Cystotomy,  201 
Cysts,,  serous,  of  the  ear,  429 


DE.\FNESS,  partial  or  complete,  438 
Debility  of  the  bladder,  195 
Decayed  meat  poisoning,  63 
Deep   parendryinatous   inflammation   of 

the  cornea,  408 
Deformans,  arthritis,  34 
Dentition,  40 
Dermatophagus  canis,  465 
Dermoid  of  the  cornea,  413 
Detachment  of  the  retina,  424 
Diabetes  insipidus,  318 

meUitus,  316 
Diagnosis  of  the  larynx  and  windpipe,  117 
Diaphragm,  convulsion  of  the,  236 
Diastasis  of  the  vertebral  column,  251 
Diffuse  peritonitis,  95 

phlegmone,  360 
Digestive  apparatus,  disease  of,  11 
Digestion  of  albumin,  22 

of  hydrocarbonaceous  food,  22 

of  meat,  22 

of  milk,  22 

of  the  stomach  on  a  meat  diet,  22 
Dilation  of  the  bladder,  196 

of  the  heart,  163 
Dilatation  of  the  pelvis  of  the  kidney,  189 

of  the  (esophagus,  51 
Dimensions  of  the  thorax,  119 
Dipylidium  canerium,  87 
Discission,  418 

Diseased  malformations  of  the  joints,  341 
Diseases,  constitutional,  312 

of    the    air-passages    and    bronchial 
tubes,  137 

of  the  aortic  valve,  162 

of  the  articulations,  337 

of  the  bones,  323 

of  the  bladder,  191 

of  the  brain  and  its  coverings,  235 

of  the  bursa  mucosa,  287 

of  the  circulatory  apparatus,  J54 

of  the  claws  and  foot-pads,  378 


498 


INDEX 


Diseases  of  the  conjunctiva,  401 
of  the  cornea,  406 
of  the  crystalline  lens,  416 
of  the  digestive  apparatus,  11 
of  the  ear,  429 
of  the  eyes,  395 

of  the  female  sexual  organs,  211 
of  the  heart,  158 
muscle,  163 
Hodges,  315 
of  the  intestines,  58 
of  the  joints,  337 
of  the  kidneys,  181 
of  the  lachrymal  duct,  399 
of  the  larynx,  133 
of  the  lens,  416 
of  the  liver,  404 
of  the  lungs,  411 
of  the  male  sexual  organs,  204 
producing    malformation    of    the 

joints,  337 
of  the  mammary  glands,  225 
of  the  membrane  nicitans,  399 
of  the  mouth  , tongue,  and  salivary 

glands,  34 
of  the  muscles,  353 
of  the  nasal  cavities,  128 
of  the  nervous  portion  of  the  eye,  422 
of  the  nervous  system,  228 
of  the  oesophagus,  48 
of  the  optic  nerve,  422 
ofthe  organs  of  locomotion,  323 
of  the  penis  and  prepuce,  206 
of  the  pericardium,  165 
of  the  peritoneum,  95 
of  the  pleura,  147 
of  the  prostate,  202 
of  the  respiratory  organs,  115 
of  the  retina,  423 
of  the  sahvary  glands,  34 
of   the    sclerotic    coat    of   the    eve, 

422 
of  the  sexual  apparatus,  152 
of  the  skin,  441 
of  the  spinal  cord  and  its  coverings, 

243 
of  the  stomach,  52 
of  the  teeth,  37 
of  the  tendons,  356 
of  the  testicle  and  its  covering,  208 
of  the  tongue,  36 
of  the  urinary  and  sexual  apparatus, 

169 
of  the  vagina  and  the  uterus,  211 
of  the  vitreous  humor,  423 
of  true  infection,  267 
resulting  from  the  septic  infection  of 

wounds,  359 
septic  and  pysemic,  287 
Disinfection  of  wounds,  363 
Dislocation  of  the  elbow,  349 
of  the  lower  jaw,  348 
of  the  patella,  350 
Dislocations,  347 


Disicative  keratitis,  408 
Distemper,  267 

bench-show,  282 

false,  282 
Distoma  echinatum,  94 

heterophytes,  94 
Distortions  of  the  joints,  341 
Disturbance  of  consciousness,  228 

of  motility,  229 

of  reflex  irribility,  234 

of  sensitiveness,  228 
Diuretics  in  dropsy,  89 
Diverticulum  of  the  rectum,  80 
Dochmius,  93 

duodenalis,  93 

stenocephalus,  93 

trigonocephalus,  93 

uncincoriasis,  94 
Dog  flea,  462 

lice,  463 

passing  the  catheter  in  the,  152 

parasites,  461 
Drainage  of  the  wounds,  364 
Dropsy,  abdominal,  99 

of  the  anterior  chamber,  423 

of  the  chest,  151 

of  the  pericardium,  166 
Dyspepsia,  52 

chronic,  53 


pAR,  diseases  of,  429 

*-'     inflammation  of  external,  432 

parasitic  canker,  439 
diseases  of  the,  439 
Eclampsia,  260 
Ectropion,  397 
Eczema,  445 

chronic,  448 

moist,  446 

parasitic,  465 

of  the  toes,  450 

seborrhoeicum,  450 
Elbow,  dislocation  of,  449 

hygroma  of  the,  357 
Emasculating  bot-fly,  185 
Emetics,  21 
Emphysema,  6 

of  the  lungs,  138,  146 
Endocarditis,  acute,  158 

ulcerosa,  158 
Enteritis  catarrhalis,  59 
Enterotomy,  71 
Enterectomy,  72 
Entero-anastomosis,  72 
Entropion,  395 

operation  for,  396 
Enucleation,  370 
Epilepsv,  255 
Epistaxis,  129 

Epithelium  in  the  urine,  158 
Epulides  41 
Erythema,  442 
Ether,  493 


INDEX 


499 


Examination,  general,  1 

of  the  bladder,  172 

of  the  digestive  apparatus,  11 

of  the  circulatory  apparatus,  154 

of  the  heart,  154 

of  the  kidney,  173 

of  the  mouth  and  throat,  2 

of  the  nervous  system,  228 

of  the  nose,  115 

of  the  oesophagus,  16 

of  the  prepuce  and  urethra,  1 69 

of  the  prostate,  169 

of  the  stomach,  17 

of  the  urinary  apparatus,  169 

of  the  urine,  173 

physical,  of  the  lungs,  115 
Exarticulation,  376 
Excessive  venereal  excitement,  223 
Exophthalraus,  425 
External  canker,  432 

concha,  ulceration  of  the,  432 
Eyeball,  prolapse  of,  425 
Eyes,  diseases  of  the,  395 
Eyelids,  350 

affections  of,  395 

blennorrhoea  of,  403 

closure  of,  395 

inversion  of,  395 

turning  in  of,  353 

turning  out  of,  397 

inflammation  of  the,  398 
Eye,  dropsy  of  the  anterior  chamber,  423 

enucleation  of,  427 

inflammatory  processes  of,  422 

opening  the  capsule  of,  418 

purulent  inflammation  of,  423 

removal  of  the,  427 
Expansion  of  the  stomach,  54 


■pACIAL  nerves,  paralysis  of  the,  253 

*■  twitching,  255 

Falling  out  of  the  hair,  458 

False  distemper,  282 

Fat  in  urine,  117 

Fatty  liver,  109 

Favus,  475 

Feces,  28 

Female  sexual  organs,  diseases  of,  211 

Femoral  hernia,  393 

Fermentation  test,  181 

Fever,  308 

aseptic  wound,  361 

puerperal,  216 

purulent,  362 

septic  wound,  361 
Fibrinous  pneumonia,  146 
Fibroma,  480 
Filiaria,  hoematica,  167 

immitis,  167,  475 

in  the  blood,  167 

mediunsis,  475 

tracheo-bronchialis,  140 
Filix  mas,  91 


Flea,  dog,  462 

Follicular  mange,  469 

Foreign  bodies  in  oesophagus,  48 

in  the  stomach,  55 

in  the  tongue,  36 
Fractures,  general  classification  of,  292 

of  the  bones,  325 

union  of,  328 
Frontal  sinusis,  catarrh  of  the,  130 
Frost-bite,  370 
Furunculosis,  455 


pALLSTONES,  110 

^-^     Gangrene  of  the  tongue,  36 

Gastricismus,  52 

Gastritis  catarrhalis,  52 

Gastro-intestinal  inflammation,  63 

General  classification  of  fractures,  326 

examination,  1 
Gestation,  219 

Glands,  anal  abscesses  of,  79 
Glaucoma,  423 
Goitre,  264 
Gonorrhoea,  207 

of  the  prepuce,  207 
Gums,  tumors  of,  40 


LJ^MATOZOON,  Lewisi,  168 
*•  *     subulatum,  168 
Hair-follicles,  inflammation  of,  455 
Hair,  falling  out  of,  458 
Hardening  of  the  liver,  108 
Harvest  bug,  465 
Head,  cold  in,  128 

mucous  membranes  of,  4 
Healing  process  of  a  wound,  366 
Heart,  dilation  of  the,  163 

diseases  of  the,  158 

muscles,  parasites  in  the,  164 
disease  of  the,  163 

nervous  palpitation  of  the,  164 

palpitations,  164 

sounds  of  the,  156 

tumors  of  the,  164 

valvular  defects  of  the,  160 
diseases  of  the,  160 
Hsematoma,  429 
Hsemaeopinus  piliferus,  463 
Hsemoglobinuria,  307 
Hebra's  potash-soap,  391 
Heller's  test,  179 
Helminthiasis,  82 
Hemathorax,  153 
Hemiplegia  laryngis,  136 
Hemoglobinuria  and  piroplasmosis,  307 
Hemorrhage,  358 

cerebral,  237 

controlling  of,  364 

of  the  pericardium,  166 

of  the  spinal  cord,  251 

of  the  retina,  424 
Hemorrhoids,  81 


:oo 


INDEX 


He  par,  adiposum,  109 
Hepatitis,  108 

acute  parenchymatous,  108 

interstitial,  108 
Hernia,  381 

abdominal,  381 

femoral,  393 

inguinal  387 

in  the  bitch,  389 

irreducible,  383 

perineal,  394 

pseudo-perineal,  80 

reducible,  382 

scrotal,  387 

umbilical,  391 
Herniotomy,  386 
Herpes  tonsurans,  476 
Hiccough,  263 
Hip-dislocation  of  the,  252 
Hobday  apparatus,  492 
Hodge's  disease,  315 
Honey  cysts,  45 
Hordeolum,  399 

Hydrocarbonaceous  food  digestion  of,  22 
Hydrocephalus,  241 
Hydrocele,  391 

Hydrocyanic-acid  poisoning,  112 
Hydronephrosis,  189 
Hydrophobia,  290 
Hydrophthalmus,  423 
Hydrops  abdominalis,  99 
Hydrothorax,  151 
Hygroma  of  the  elbow,  357 
Hypersemia  of  the  brain,  235 

of  the  liver,  107 
Hypersesthesia,  229 


ICTERUS  catarrhalis,  104 
■^     Imperforate  anus,  78 
Imptegio,  460 
Increased  temperature,  7 
Induration,  chronic,  of  the  lungs,  143 
Infectious  bronchial  catarrh,  232 

genital  tumors.  486 

hemorrhagic  gastroenteritis,  383 
Inflammatory    conditions    of    the    cuta- 
neous membrane,  441 
Inflammation,   mycotic,   of  the  stomach 
and  intestines,  63 

of  the  anal  pouches,  78 

of  the  brain,  239 

of  the  brain-mass,  239 

of  the  cerebral  matter,  239 

of  the  cerebral  membranes,  239 

of  the  choroid,  422 

of  the  conjunctiva,  401 

of  the  external  ear,  432 

of  the  eye,  422 

of  the  eyelids,_  398  _ 

of  the  gastro-intestinal,  62 

of  the  hair-follicles,  455 

of  the  iris,  422 

of  the  joints,  337 


Inflammation  of  the  joints,  purulent,  339 
rheumatic,  340 

of  the  kidneys,  181 

of  the  liver,  108 

of  the  lungs,  141 

of  the  lymphatics,  360  . 

of  the  mammary  gland,  225 

of    the  mucous  membranes  of  the 
mouth,  34 

of   the   mucous   membranes    of   the 
throat,  46 

of   the   papilla   of   the   optic   nerve, 
424 

of  the  pelvis  of  the  kidney,  188 

of  the  peritoneum,  95 

of  the  pleura,  147 

of  the  prostate,  204 

of  the  scrotum,  208 

of  the  salivary  glands,  43 

of  the  sclerotic  coat,  422 

of  the  spinal  cord,  210 

of  the  testicle,  209 

of  the  uterus,  216 

of  the  urethra,  203 

of  the  vagina,  211 

of  the  vulva  and  vagina,  211 

purulent,  of  the  liver,  109 

toxic,  of  the  stomach  and  intestines, 
63 
Inflammatory  processes  of  the  eye,  422 
Inflamed  claws,  379 

hemorrhagis  gastro-intentes,  283 
Inguinal  hernia,  387 

in  the  bitch,  389 
Ingrowing  claws,  378 
Injuries  of  the  cornea,  414 

of  the  joints,  344 

to  the  testicles  and  scrotum,  209 
Inoculation,  Pasteur's  method,  305 
Internal  canker,  434 

parasites,  82 
Interstitial  hepatitis,  108 

nephritis,  chronic,  184 

pneumonia-chronic,  145 
Intestinal  parasites,  82 

catarrh,  58 
Intestines,  contraction  of,  65 

diseases  of,  58 

mycotic    inflammation  of,  63 

obstruction  of,  65 

physical  examination  of,  25 

stenosis  of,  63 

toxic  inflammation  of,  63 
Inversion  of  the  eyelid,  395 

of  the  stomach,  55 
lodoform-poisoning,  112 
Irreducible  hernia,  383 
Irregularities  of  the  sexual  instinct,  222 
Iris,  anomalies  of  the,  422 

colobroma,  422 

inflammation  of,  422 
Irritalile  cough,  chronic,  135 
Iritis,  422 
Ischiadicus,  paralysis  of  the,  254 


INDEX 


501 


Itching  skin  without  presence  of  rash,  450 
Ixodes  ricinus,  405 


lAFXDICE,  catarrhal,  104 
*-'     malignant,  307 
Jaw,  dislocation  of,  348 
Joints,  acute,  synovial  inflammation  of, 
338 

chronic  serous  inflammation,  338 

contusions  of,  344 

distortions  of,  341 

diseases  of,  337 

inflammation  of,  337 

injuries  of,  344 

luxations  of,  347 

malforn^ation  of,  341 

puncturing  of,  342 

purulent  inflammation  of,  339 

rheumatic  inflammation  of,  340 

suppuration  of,  339 

wounds  of,  344 


1<-AMALA,  91 

'  *•     Kennel  distemper,  267 

Keratitis,  406 

disiccative,  414 

parenchymatosa,  408 

profunda,  403 

superficialis,  407 
Kidneys,  abscess  of,  187 

acute  inflammation  of,  181 

amyloid,  186 

animal  parasites  of  the,  190 

chronic  inflammation  of,  184 

dilatation  of  the  pehis  of  the,  189 

diseases  of,  181 

examination  of  the,  173 

inflammation  of,  181 
of  the  pelvis,  188 

tumors  of  the,  190 
Koch's  test,  179 
Kusso,  92 


T  ARDACEOUS  liver.  110 
^     Laryngeal  catarrli,  acute.  133 
Lachrymal,  diseases  of  the,  399 
Laryngitis,  acute,  133 

chronic,  135 
Laryngoscope,  118 

Larvnx,  and  \\'indpipe,  phvsical  diagnosis 
"of  the,  117 

chronic  catarrh  of,  135 

diseases  of,  133 
Left  venous  opening,  stenosis  of  the,  162 
Lapro-enterotomv,  70 
Leptus  autumnalls,  465 
Leucoma,  415 
Leukaemia,  313 
Lice,  dog,  463 

Linear,  extraction  of  thecrys  talline  lens, 
419 


Linguatula  taenoides,  131 
Lipoma,  481 
Lithiasis,  197 
Liver,  abscess  of,  109 

amyloid,  110 

cirrhosis  of,  108 

congestion  of  the,  104 

congestive  hypersemia  of,  109 

diseases  of,  104 

fatty,  109 

hardening  of,  108 

hypersemia  of,  109 

inflammation  of,  108 

lardaceous,  110 

neoformations  of,  110 

parasites  of,  110 

physical  examination  of,  32 

purulent  inflammation  of,  109 

stagnating  hypera^mia  of,  107 
Lobular    extraction    of    the    crystalline 
lens,  419 

pneumonia,  141 
Local  temperature,  7 
Lockjaw,  309 

Locomotion,  diseases  of  organs  of,  323 
Lower  jaw,  dislocation  of,  348 

paralj^sis  of,  253 
Lungs,  acute  hypersemia  of,  145 

auscultation  of  the,  125 

blackening  of  the,  129 

catarrhal  inflammation  of,  141 

chronic  induration  of,  141 

cirrhosis  of,  143 

congestion  of  the,  145 

croupal  inflammation  of  the,  146 

diseases  of,  141 

emphysema  of,  146 

neo-formations  of  the,  147 

oedema  of,  141,  144 

physical  diagnosis  of,  119 
Lunguatula  denticulata,  131 
Luxations  of  the  joints,  347 

of  the  spine,  251 
Lymphadenia,  315 
Lymphangitis,  360 
Lymphatics,  inflammation  of,  360 


MALE,  castration  of  the,  210 
fern,  91 

sexual  organs,  diseases  of,  204 
Malformation  of  the  joints,  341 
of  the  rectum  and  anus,  48 
Malformations     of    the    cavity    of    the 

mouth,  41 
Malignant  jaundice,  307 

oedema,  288 
Mammary  gland,  diseases  of  the,  225 
inflammation  of,  225 
neo-formation  of  the,  226 
Mammitis,  225 
Mange,  follicular,  467 
red,  445 
sarcoptic,  465 


502 


IXDEX 


Meat-diet,  digestion,  22 
Medulla  obllongata,  paralysis  of,  243 
Membrana    nictitans,    diseases    of    the, 
399 

removal  of,  400 
Meningitis,  239 
Menstruation  of  bitch,  219 
Mercury-poisoning,  113 
Metritis,  215 

catarrhal,  215 

septic,  216 
Milk-digestion,  22 
Moist  eczema,  446 

scab,  healing  under,  359 
Motor  paralysis  of  the  trigeminus,  253 

symptoms  of  paralysis,  229 
Mouth  and  throat,  condition  of  the,  12 

examination  of,  12 

diseases  of,  34 

the  mucous  membrane  of,  34 

malformations  of,  41 

ulcerous  inflammation  of,  34 
Mouth-gag,  13 
Mouth,  warts  in,  42 
Mucous  cysts,  45 

membrane   of    the    mouth,    disease 
of,  34 

membranes    of    the    head,    general 
examination  of,  14 

membranes  of  the  throat,  inflamma- 
tion of,  46 

ulcerous  inflammation  of,  34 
Multiple  periositas,  336 
Mumps, 43 

Muscles,  diseases  of  the,  353 
Muscular  rheumatism,  353 
Mycotic   inflammation    of   the   stomach 

and  intestines,  63 
Myehtis,  243 
Myoma,  487 
Myxoma,  486 


MASAL  catarrh,  128 

*^     cavities,  diseases  of,  128 

tumors  of  the,  130 
Neck,  abscess  of,  45 
Necrotic  stomatitis,  34 
Neoformation  of  the  bladder,  203 

of  the  bones,  336 

of  the  glans  penis  and  prepuce,  208 

of  the  liver,  110 

of  the  lungs,  147 

of  the  mammary  glands,  226 

of  the  testicles,  209 

of  the  uterus,  218 

of  the  vagina,  215 
Nephritic  stones,  190 
Nephritis,  181 

acute,  182 

chronic,  184 

interstitial,  184 

suppurative,  187 
Nerves,  paralysis  of  the,  252 


Nervous  palpitation  of  the  heart,  164 

portion  of  the  eye,  diseases  of,  422 

system,  diseases  of,  228 
examination  of,  228 
Nettlerash,  444 
Noma,  461 
Nose,  Weeding  of  the,  129 

catarrh  of,  113,  128 

examination  of,  115 
Number  and  character  of  the  respiratory 

movements,  120 
Nuritive  condition,  general  examination 

of,  3      _ 
Nux-vomica  poisoning,  113 
Nymphomania,  223 

OBESITY,  319 
Obstetrics,  219 
Obstipation,  65 
Obstruction  of  the  intestines,  65 

of  the  oesophagus,  50 
Obturator  nerve,  paralysis  of  the,  254 
Odor  of  urine,  175 
ffidema,  and  Parasites  of  the  brain,  242 

of  the  lungs,  144  malignant,  288 
(Esophagotomy,  50 
ffisophagus,  diseases  of,  48 

dilitation  of,  51 

examination  of,  16 

foreign  bodies  in,  48 
Opening  of  the  capsule  of  the  eye,  418 
Operation  for  entropion,  395 
Ophthalmia,  catarrhal,  403 

purulent,  403 
Optic  nerve,  disease  of,  424 
Orchitis,  209 
Osteoma,  487 

malaria,  325 
Ostitismus  universalis,  336 
Otitis  externa,  432 

parasitic,  439 
Ovariotomy,  223 
Oxalates,  178 
Oxyuris  vermicularis,  93 

PACHYMENINGITIS,  239 

*       Panophthalmitis,  423 

Pads,  contusion  of  the,  280 

Pancreas,  33 

Papilla  of  the  optic  nerve,  inflammation  of 

the,  424 
Papilloma,  483 
Paralysis,  229 

of  the  anterior  limbs,  230 

of  the  bladder,  195 

of  the  cruralis,  230 

of  the  facial  nerves,  252 

of  the  lower  jaw,  253 

of  the  ischiadius,  254 

of  the  medulla  oblongata,  243 

of  the  nerves,  252 

of  the  obturator  nerve,  254 

of  the  oesophagus,  51 


INDEX 


503 


Paralysis  of  the  posterior  limbs,  244 

of  the  radial  nerve,  253 

of  the  sphincters,  245 
Paraphimosis,  206 
Parasites,  82 

dog,  463 

internal,  82 

in  the  brain,  242 

in  the  heart  muscles,  164 

intestinal,  82 

of  the  kidney,  190 

of  the  stomach,  57 

tapeworm,  84 
Parasitic,  bronchitis,  140 

canker  of  the  ear,  439 

cezema,  445 

otitis,  439 
Parenchymatous  hepatitis,  108 

inflammation  of  the  tongue,  36 

nephritis,  chronic,  184 
Parotid,  abscess  of,  44 
Parotitis,  43 

Passing  the  catheter,  169 
Pasteur's  method  of  inoculation,  300 
Patella,  dislocation  of,  350 
Pelvis  of    the  kidney,   inflammation  of, 

188 
Pemphigus,  460 
Penis,  diseases  of,  206 
Pentastoma  denticulatum,  131 

influenza,  131 

tsenioides,  131 
Percussion  of  the  thorax,  123 
Pericardium,  diseases  of  the,  165 

dropsy  of  the,  166 

hemorrhage  of  the,  166 
Pericarditis,  165 
Perineal  hernia,  394 
Periostitis  alveolar,  38 
Perinephritic  abscesses,  187 
Persistant  papillary  membrane,  422 
Peritonitis,  95 

acute  diffuse,  95 

chronic,  98 

circumscribed,  97 
Peritoneum,  diseases  of,  95 

inflammation  of,  95 

physical  examination  of,  25 
Pharyngitis,  46 

chronic,  47 
Phimosis,  206 
Phlegmone,  359 
Phosphorus-poisoning,  112 
Phthisis,  143 

Physical    diagnosis    of    the    larynx    and 
%\'indpipe,  117 
of  the   bowel  and   peritoneum, 
25 

condition,  the,  1 
of  the  liver,  32 
of  the  lungs,  119 
of  the  pancreas,  33 
of  the  spleen,  33 
of  the  respiratory  apparatus,  115 


Piroplasmosis  and  hemoglobinuria,  307 
Pleura,  diseases  of,  147 

inflammation  of,  147 
Pleural  tuberculosis,  304 
Pleurisy,  147 
Pleuritis,  147 
Pneumonia,  141 

broncho-,  141 

catarrhal,  141 

chronic  interstitial,  143 

croupal,  146 

filirinous,  146 

lobular,  141 

traumatic,  141 
Pneumothorax,  152 
Poisoning  by  arsenic.  111 

by  carbolic  acid,  112 

by  caustic  alkalies.  111 
acids.   111 

by  chloroform,  113 

by     gas,      coal,      carbondioxide     or 
illuminating,  114 

by  hydrocyanic  acid,  112 

by  iodine,  114 

by  iodoform,  112 

by  mercury,  113 

by  nux  vomica,  113 

by  phosphorus,  112 

by  prussic  acid,  112 

by  strychnine,  113 
Poisons,  111 
Pomegranate,  82 
Polyneuriti'^  infectiosa,  255 
Posterior  chamber  of  the  ej-e,  diseases  of, 
422 

limbs,  paralysis  of,  244 
Potash-soap,  Hebra's,  391 
Prepuce,  diseases  of,  206 

examination  of,  169 

gonorrha?a  of,  207 

neoformations  of,  208 
Priessnitz's  compress,  322 
Probang,  49 
Proglottides,  85 
Prolapse  of  the  eyeball,  425 

of  the  rectum,  74 

of  the  uterus,  216 

of  the  vagina,  212 
Pulsations  of  the  henrt,  156 
Prolapsus  bulbi,  425 

of  rectum,  reduction  of,  74 

uteri,  212 

vaginae,  212 
Prostate,  cancer  of,  206 

diseases  of,  204 

examination  of,  204 

inflammation  of,  204 

tumors  of,  206 
Prostatitis,  204 

chronic,  205 
Prurigo,  459 
Pruritis,  459 

Prussic-acid  poisoning,  112 
Pseudo-leukaemia,  315 


504 


INDEX 


Pesudo-perineal  hernia,  80 

Psychosis,  262 

Pterygium,  414 

PtyaUsm,  36 

Puerperal  fever,  216 

Pulcx,  462 

Puncturing;  the  abdomen,  103 

the  joints,  342 
Purulent  conjunctivitis,  403 

inflammation  of  the  eye,  403 
of  the  joints,  339 
of  the  liver,  109 

ophthalmia,  403 
Pus  in  the  frontal  sinuses,  130 
Puncture  of  the  cavity  of  the  chest,  150 
Pyajmia,  362 
Pyarthrosis,  339 
Pyelitis,  188 
Pyelonephritis,  187 


DABIES,  290 

*^     Radial  nerve,  paralysis  of,  253 

Ranula,  42 

Rare  diseases  of  the  brain,  241 

Reaction  of  urine,  175 

Rectum,  and  anus,  malformations  of,  78 

preternatural,  78 

prolapsus  of,  74 
Reflex  irritability,  disturbance  of,  234 
Red  mange,  445 
Reducible  hernia,  382 
Removal  of  the  eye-ball,  427 

of  the  membrana  nictitans,  408 
Renal  cylinders,  179 

hypergemia,  186 
Respiratory  apparatus,  physical  exami- 
nation of,  115 

movements,  number  and  character 
of,  120 

organs,  diseases  of,  115 
Retina,  detachment  of,  424 

diseases  of,  424 

hemorrhage  of,  424 
Re+roflection  of  the  bladder,  203 
Reversion  of  the  stomach,  55 
Rhachitis,  323 
Rheumatic  arthritis,  340 

inflammation  of  the  joints,  340 
Rheumatism,  muscular,  353 
Rhinitis,  128 

muscular,  353 
Rickets,  323 
Round  worms,  82 
Rupture,  381 

of  the  bladder,  198 


CAINT  Vitus  dance,  259 

^     Salivary  glands,  inflammation  of,  43 

Sarcocele,  391 

Sarcoma,  482 

melanotic,  335 
Sarcoptes  scabiei,  465 


Sarcoptic  mange,  465 
Scalds,  burns  and,  369 
Sclerotic  coat,  diseases  of,  422 
Scrotum,  injuries  of,  209 
Scurvy,  321 
Seborrhoea,  459 
oleossa,  460 
prolputi,  460 
Septic  and  pysemic  diseases,  287 
infection  of  wounds,  359 

metritis,  216 
-wound  fever,  361 
Septicopyjemia,  287 
Serous  cyst  of  ear,  429 

inflammation  of  the  joints,  chronic, 
338 
Sexual  apparatus,  diseases  of,  169 
desire,  irregularities,  222 
loss  c-f,  222 
Shape  of  the  cavity  of  the  chest,  119 
Skin  affections  caused  by  animal  para- 
sites, 461 
caused  by  vegetable  parasites, 
475 
and  subcutaneous  membranes,  gen- 
eral examination  of,  5 
atrophic  conditions  of,  407 
diseases  of,  441 

non-parasitic  diseases  of,  442 
caused  by  worms,  474 
inflammatory  conditions  of,  384 
Snake  bite,  373 
Softening  of  the  bones,  325 
Sore-throat,  46 
Sounds  of  the  heart,  156 
Specific  gra\aty  of  iirine,  175 
Speculum,  13,' 28.  212 
Sphincters,  paralysis  of,  245 
Spinal    cord,    chronic    inflammation    of, 
246 
compression  of,  250 
concussion  of,  251 
hemorrhages  of,  251 
inflammation  of,  243 
membranes,  inflammation  of,  243 
myelitis,  243 
Spine,  nutritive  disorders  of,  212 
Spiroptera  sanguinolenta,  51,  168 
Spleen,  33 
Sprains,  346 

Stagnating  hyperaemia  of  the  liver,  167 
Stenosis  of  the  aorta  opening,  162 
of  the  oesophagus,  50 
of  the  intestines,  65 
of  the  left  venous  opening,  162 
Stitches,  365 
Stomacace,  34 

Stomach,  acute  catarrh  of,  52 
cancer  of,  57 
chronic  catarrh  of,  53 
digestion  of  milk,  22 
dilatation  of,  54 
diseases  of,  52 
examination  of,  17 


INDEX 


505 


Stomach,  expansion  of,  54 

foreign  bodies  in,  55 

inversion  of,  55 

meat  diet,  digestion  of,  22 

mycotic  inflammation  of,  03 

parasites  of,  57 

reversion  of,  55 

-pump,  20 

toxic  inflammation  of,  G3 

ulceration  of,  57 
Stomatitis,  34 

necrotic,  34 

ulcerative,  34 
Stone  in  the  bladder,  197 
Stones,  nephritic,  190 
Stricture  of  the  urethra,  202 
Strongylus  bronchialis  lanis,  140 

vasorum,  141,  168 
Structure  and  constitution  of  the  body,  3 
Struma,  264 

Strychnine-poisoning,  113 
St.  Vitus's  dance,  259 
Sty  of  the  eye,  399 
Sugar  in  urine,  180 
Sunstrok     ,  242 
Suppuration,  of  the  joints,  339 
Suppurative  nephritis,  87 
Syndesmitis,      401 
Synovitis  acuta  serosa,  338 

chronica  serosa,  338 
Synovial  inflammation  of  the  joints,  338 
Syringomyelia,  252 


•pABES  dorsalis,  251 
*■      Tsenia,  84 

ccenurus,  89 
cucumerina,  87 
echinococcus,  89 
lineatu,  89 
litterata,  89 
marginata,  87 
serialis,  89 
serrata,  85 
Tseniafuges,  91 
Tail,  amputation  of,  375 

wounds  on  the  tip  of,  374 
Tapeworms,  84 
Tapping  the  abdomen,  103 
Teeth,  caries  of,  38 
diseases  of,  37 
Temperature,  7 
increased,  7 
subnormal,  9 
Tendons,  diseases  of,  356 
Test,  acetic,  179 
bismuth,  181 
fermentation,  181 
Heller's,  176 
Kochs'  179 
Trommer's  180 
tuberculin,  306 
Testicles,  diseases  of,  208 
inflammation  of,  209 


Testicles,  injuries  of,  209 

neoformations  of,  209 
Tetanus,  309 

Therapeutics  of  tumors,  490 
Thorax,  auscultation  of,  125 

dimensions  of,  119 

percussion  of,  123 
Throat,     inflammation    of    the    mucous 

membranes,  46 
Thyroid  gland,  inflammation  of,  266 

hypertrophy  of,  264 
Tobacco-bag  stitch,  77 
Toes,  eczema  of,  451 
Tongue,  diseases  of,  36 

foreign  bodies  in,  36 

gangrene  of,  36 

parenchymatous  inflammation  of,  37 
Toxic  inflammation  of  the  stomach  and 

intestines,  63 
Trachea,  physical  examination  of,  117 
Traumatic  lesions  of  the  brain,  338 
Treatment  of  wounds,  357 
Trichocephalus,  depressiusculus,  94 
Trichodectes  latus  canis,  463 
Trigeminus,  motor  paralysis  of,  253 
Trommer's  test,  180 
True  infection,  diseases  of,  267 
Trypanosomiasis,  478 
Tuberculin  test,  306 
Tuberculosis,  302 

pleural,  304 
Tumors,  480 

cancerous,  484 

cutaneous,  267 

infectious  genital,  488 

of  the  gums,  40 

of  the  heart,  164 

of  the  nasal  cavities,  130 

of  the  prostate,  206 

of  the  kidneys,  190 

particularly  those  of  the  skin,  480 

therapeutics  of,  490 
Turning  in  of  the  eyelid,  395 

out  of  the  eyelid,  397 
Twitching,  facial,  255 


T  TMBILICAL  hernia,  391 
^     Ulceration,  367 

of  the  cornea,  410 
of  the  stomach,  57 
Ulcerations  of  the  external  concha,  432 

of  the  stomach,  57 
Ulcerative  stomatitis,  34 
Ulcers  and  ulceration,  367 
Ulcerous    inflammation    of   the    mouth, 

34 
Union  of  fractures,  325 
Uraemia,  320 
Urethra,  examination  of,  169 

inflammation  of,  203 

stricture  of,  202 
Urethrotomy,  200 
Uric  calculi,  197 


506 


INDEX 


Urinarjf  apparatus,  examination  of,  109 

diseases  of,  169 
Urine,  albumin  in,  179 

amount  of,  173 

color  of,  174 

crystals,  178 

epithelium  in,  177 

examination  of,  173 

fat  in,  175 

in  the  abdominal  cavity,  198 

odor  of,  175 

reaction  of,  175 

specific  gravity  of,  175 

sugar  in,  180 

transparency  of,  175 
Urticaria,  444 
Uterus,  diseases  of,  215 

inflammation  of,  215 

neoformation  of,  218 

prolapse  of,  212,  216 

removal  of,  222 

WAGINA,  diseases  of,  211 
*  inflammation  of,  211 

neoformations  of,  215 


Vagina,  prolapse  of,  212 

Vaginitis,  211 

Valvular  defects  of  the  heart,  160 

diseases  of  the  heart,  160 
Vegetable  parasites,  cutaneous  affections 

caused  by,  175 
Vertebral  column,  diastasis  of,  251 
Vitreous  humor,  diseases  of,  424 
Vulva    and    vagina,     inflammation    of, 

211 


VWARTS  in  the  mouth,  42 
^^      Windpipe,    physical    diagnosis    of, 

117 
Worms,  intestinal,  82 
Wounds  and  their  treatment,  357 

diseases    resulting    from    the    septic 

infection  of,  359 
treatment  of,  364 
on  the  tip  of  the  tail,  374 


"VELLOW  mucous  membranes,  104 


71 


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